What, exactly, is an emotion?

This question has long been debated. Nonetheless, this complex state can be said to involve cognitive appraisals, physiological changes, and behavioral responses. Take, for instance, fear—one of the most researched emotions. An event or situation that triggers fear results in a cognitive appraisal, a thought that evaluates the situation. This, in turn, brings about a physiological change in the body, such as an increased heart rate, increased temperature, or tense muscles. A behavioral response, such as screaming or running away, often follows.

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Researchers Alan S. Cowen and Dacher Keltner at the University of California, Berkeley have identified 27 categories of emotions, all of which serve a purpose. Without them, we would not know when to feel alarmed (anxiety), let down (disappointment), or safe (relaxation), for example. Emotions also inform others about our inner state, which in turn evokes their own emotions and promotes various social interactions.

Emotions become an issue when they are overwhelming, inappropriate for the situation, or we experience negative ones too often. Many of our difficulties with emotions come from the way we think about the world, things around us, things that happened to us, and so forth. Intense emotions can be distressing and may interfere with our ability to carry out day-to-day activities and the way we interact with others. Therefore, it is important to know how to manage intense emotions.

Cognitive behavioral therapy encourages individuals to do the following:

1. Label Your Emotions

The first step to help manage emotional discomfort is to label the emotions we are experiencing. It is important to become familiar with the different types of emotions, including those that are more complex (such as contempt, love, and remorse), so we can correctly label our experience of them.

2. Identify Thoughts Behind Your Emotions

The thoughts that precede our emotions also provide additional insights into our difficulties. The thought “I’m not as smart as other people at this meeting” can result in great distress and limit our verbal exchanges. However, we can change the way we think by asking ourselves if what we are thinking is true, helpful, or kind. If the answer is no, we have a way to modify our thinking (e.g., “People at this meeting are probably not worried about my intelligence”). This is known as cognitive reappraisal.

3. Carefully Examine Any Other Emotions

Believe it or not, many of us do not correctly identify emotions. We may say we are sad when what we are really experiencing is frustration or shame. Therefore, it is important to go back and reexamine what we are experiencing. Our thoughts should match our feelings. It is also important to realize we may be experiencing more than one emotion. This step enhances our understanding of what we are experiencing.

4. Rate Your Emotions

For experiences that seem too hard to manage or intolerable, it is helpful to rate the degree of emotion we are experiencing. This can be done using a scale of 0-10 or by giving a percentage of how much an emotion is being felt at a given moment. Ratings not only help us determine which emotions we are struggling with the most, they give us an idea of how we perceive the difficulty. A bonus is that ratings can be a great tool for monitoring improvements in the way we are feeling.

5. Practice Acceptance

There are times when cognitive reappraisal is difficult, especially if a professional is not there to help. More recent literature has evolved suggesting it is helpful, however, to notice the full experience of emotions with openness and curiosity. This practice involves recognizing patterns of thinking (e.g., “I’m often panicked”), physiological sensations (e.g., muscle tension), and maladaptive behavior (e.g., avoiding communication of personal needs) without changing them. This allows you to create “space” for these less pleasant emotions.

6. Increase Positive Emotions

Give attention to positive events, things that interest you, and practice gratitude. We can proactively modify our feelings not only by changing the way we think or creating space, but by attending to more pleasant experiences.

Conclusion

To successfully implement these strategies, you will need to practice, practice, and practice again. Change takes time and patience. Do not overemphasize reduction of negative emotions; remember, emotions are there for a reason. It is best to focus on personal growth and improvement. And if you are not experiencing the desired improvements, it may be time to seek professional help.

References:

1. Aldao, A. (2008). Coping and emotion regulation. In S. Hayes & S. Hoffman (Eds.) Processed Based CBT: The Science and Core Competencies of Cognitive Behavioral Therapy (pp. 261-272). Oakland, CA: Context Press.
2. Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York, NY: Guilford Press.
3. Hockenbury, D. H., & Hockenbury, S. E. (2007). Discovering psychology. New York, NY: Worth Publishers.
4. Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
5. Papa, A., & Epstein, E. (2008). Emotions and emotion regulation. In S. Hayes & S. Hoffman (Eds.) Processed-Based CBT: The Science and Core Competencies of Cognitive Behavioral Therapy (pp. 137-152). Oakland, CA: Context Press.

“Our wounds are often the openings into the best and most beautiful parts of us.” —David Richo, PhD, MFT

“Everyone is down on pain, because they forgot something important about it: Pain is for the living. Only the dead don’t feel it.” —Jim Butcher, author

“The sweetest pleasures are those which are hardest to be won.” —Giacomo Casanova, adventurer and author

According to Sigmund Freud, we’re all pleasure seekers; it’s our fundamental nature. He said maturity is the ability to postpone desire for comfort and pleasure in order to deal with reality. Despite ongoing controversy about some of his more unusual concepts, I think he was right about this one. Humans have come up with an astounding variety of ways to change pain into pleasure. Here is a partial list of things I’ve heard people talking about just in the last week or so:

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• Marijuana (this one’s popular these days!)
• Alcohol
• Vacation
• Overeating
• Undereating
• Running
• Netflix
• Medication
• Organizing one’s closets
• Knitting
• “Zoning out”
• Caffeine
• Chocolate
• Gaming
• Music
• Overworking
• Avoiding work
• Sex

As always, these things aren’t inherently bad; many are wonderful. Like anything in life, it’s all in how these things are used, especially over time. Are we using them to avoid difficult emotions? Or are we using them to create something in our best interest?

When it comes to dealing with pain, though, there’s another approach. In meditation and 12-step recovery circles, we are often told to “just sit with it.” What does this mean?

In psychology, affect tolerance basically means this: how much of your emotion can you tolerate? Sit with? Feel? That is, without needing to take action to shut them off.

In psychology, affect tolerance basically means this: how much of your emotion can you tolerate? Sit with? Feel? That is, without needing to take action to shut them off. There is no way to precisely measure emotion or someone’s tolerance of it. However, it’s useful as one indicator of mental and emotional health.

Why would anyone want to hang out with their lousy feelings? This is a valid question, and having a clear answer in mind is pretty much a prerequisite for doing the work. Drawing on my clinical (and personal) experience, here is why I believe feeling one’s difficult feelings (and increasing one’s affect tolerance in the process) is useful:

• Because feeling our difficult feelings is what makes them go away. And I mean truly go away, not just lurk around, waiting to pop up on a rainy day. Now, there are a few caveats: The feelings have to be within the person’s window of tolerance. That is, the intensity must be somewhere in between avoiding and flooding—that “sweet spot” where the body can metabolize the feelings. In the case of complex trauma, this may take a while (and therapeutic assistance is important). The worse the trauma, the longer it may take, but the vast majority of people are capable of positive change if they put their minds to it and have a competent guide. Sitting with difficult feelings is a skill best learned from another, more experienced human being (parent, mentor, sponsor, therapist, etc.).
• Because we can’t shut down pain without also shutting down a lot of our pleasure. And I think it’s our birthright to feel the joy of just being alive. Our bodies are made to feel good in simply existing, when things are going well. Dissociation is like novocaine: it might take away the pain, but you’re not going to perceive much pleasure, either. Especially not the deeply felt, embodied pleasure and liveliness that constitute peak experiences.
• Because our experience of “bad” feelings shifts over time as we get the hang of it. “Parting is such sweet sorrow,” Shakespeare wrote. Believe it or not, there is usually a positive aspect to unpleasant feelings. But it’s like the post-workout high: you have to be “in shape” in order to start experiencing it. It may feel lousy at first.
• Because it feels fantastic when the old feelings are cleared. Many people who have habitually avoided their emotions find it difficult to feel their bodies’ signals. There’s good reason for this: our bodies are where the trauma lives. In somatic therapy circles, we call this “being disembodied” to some degree. [amazon_affiliate]
• Because emotional repression creates chronic stress, which lowers immune response and makes us vulnerable to physical illness. Dr. Gabor Maté explores this connection at length in his book When The Body Says No. This book is a synthesis of theory, his own clinical vignettes, and a lot of medical research. In the chapter titled “Stress, Hormones, Repression, and Cancer,” Dr. Maté explains the interactions between stress-responsive endocrine glands, the brain, and the immune system. “In short, for cancer causation it is not enough that DNA damage occur; also necessary are the failure of DNA repair and/or an impairment of regulated cell death. Stress and the repression of emotion can negatively affect both of those processes” (p. 92). On page 97, he continues, “Under conditions of chronic stress, the immune system may become either too confused to recognize the mutated cell clones that form the cancer or too debilitated to mount an effective attack against them.” Of course, psychotherapy can not treat medical problems and is not a substitute for medical care. In a more general way, the body of work called psychoneuroimmunology promotes the idea of well-being by increasing self-regulation, particularly downregulation, or coming out of the stress response.

In some cases, it may take a while to get to where you want to be emotionally. The cultivation of affect tolerance and a rich inner life is, I believe, a lifetime practice. But, really, is there anything more important in life than feeling truly healthy, good, and at the top of your game? Wouldn’t you rather look back five years from now and be glad you started the work then? What do you have to lose?

References:

1. Azar, B. (2001). A new take on psychoneuroimmunology. Monitor On Psychology: American Psychological Association. Retrieved from http://www.apa.org/monitor/dec01/anewtake.aspx
2. Maté, G. (2003). When the body says no: Exploring the stress-disease connection. New Jersey: Wiley and Sons.

In our first session, Isabel, an agitated newcomer to therapy, declared: “I can’t stand it when Molly is upset about anything. For 16 years, it’s been my job to keep her happy and make sure nothing interferes with her always feeling good about herself. I get anxious when she’s anxious, and I work very hard to make sure her bad feelings go away. I don’t feel like a good mother unless I make sure Molly never has uncomfortable feelings.”

At first glance, it’s easy to conclude that Isabel’s comment is the expression of a parent who wants to see their child grow up to be a happy, self-confident person. Indeed, Isabel is dedicated to raising Molly to become a person with high self-regard and the ability to have successful relationships and positive feelings about life. While this is a laudable goal, Isabel’s method for helping Molly attain it is flawed.

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Isabel’s statement captures the viewpoint of many parents who believe good parenting means never letting their child have intolerable feelings. This raises questions about the consequences for children of parents such as Isabel. I am going to explore this parenting experience and look at the potential impact on the children when parents smooth over or facilitate the avoidance of anxieties and other uncomfortable emotions.

Developing Competence with Uncomfortable Feelings

From childhood through adulthood, the ability to tolerate uncomfortable and unwanted feelings is essential for negotiating every kind of relationship. If we learn early on that we have the wherewithal to get through situations that make us uneasy, anxious, unhappy, angry, etc., we are in a good position to manage our lives. This is learned through repeated encounters with these feelings, the successes and failures of dealing with them, and finally the experience of oneself as competent to manage.

By running interference for uncomfortable feelings, Isabel has been depriving Molly of developing her capacity to regulate her own emotions by feeling them and developing comfort with them. This constricts Molly’s ability to relate and leaves her without the necessary experiences that promote resilience and competence with her anxieties. Instead, she must find ways to defend against these unwanted feeling states and/or remain dependent on others to make them tolerable.

The Dance of Anxiety

Isabel has lived her life avoiding her own difficult feelings and now is devoted to protecting Molly from unwanted emotions. For Isabel, Molly’s discomfort or unhappiness is not simply a painful affect that they both must endure; rather, it is a signal that she is failing at her job of mothering. This signal creates intolerable anxieties for Isabel which, along with Molly’s uncomfortable feelings, must be eliminated. The need to protect herself and Molly from such unwanted feelings has become a central dynamic of her mothering.

The difficult issue for both Molly and Isabel is they both require the absence of anxiety. But each makes the other anxious. Molly has been a participant in this mother-daughter dynamic for most of her 16 years. The awareness that her anxiety makes her mother anxious makes her more anxious. This creates the (often unconscious) dilemma of how to both make her mother comfortable and get rid of her own anxiety. As a result, there is a dance of anxiety in which each partner attempts, but often fails, to self-regulate and simultaneously regulate the other.

In our work together, Isabel has come to understand that her anxiety over Molly’s emotional state has created problems for their relationship:

“I know I have to stop constantly taking her emotional temperature,” Isabel said. “Things between us are not so good. She’s getting older and I can see that she has a lot of anxiety about herself and her life. In the past few months, we’ve started fighting. It’s crazy-making. Either she yells at me that I’m controlling her and that I should butt out of her life or she comes to me in an agitated state and needs to be talked off a ledge about something. The thing is, I do help her and then we have a respite and I’m the good mother again and she seems happy—and I am too.”

I asked Isabel what she thought about Molly’s recent confrontational behaviors. She sighed a large sigh and responded:

When one is deprived of learning to cope with uncomfortable feelings, it is likely that compensatory strategies for dealing with discomfort with others are developed. Relationships must be constructed to elicit positive reactions and avoid creating unwanted feelings. This limits relational possibilities and requires (consciously and unconsciously) the concealing of one’s authentic thoughts and feelings.

“Well, you and I have been talking for some time now and I get that my anxiety over Molly’s feeling states hasn’t given her tools to grow up or take risks and learn that she’s capable of taking care of herself. I know in my head it’s a good thing for Molly that she can assert herself with me. She’s been so dependent on me and I don’t like to admit that I like that. But I can still get scared when she is upset. When she confronts me, I know she is having emotions that are too much for her. I feel so guilty that I become like the scared child I was with my parents and I do whatever she wants so she won’t be upset with me.”

What Isabel is describing captures two important issues that her behavior with Molly has impacted:

1. Limit setting: Because she can’t tolerate Molly’s unhappiness, Isabel has been unable to set limits for Molly when she experiences Molly’s unhappiness or displeasure with a limit. For example, when Molly gets angry at something Isabel asserts, Isabel can’t manage her own feelings and quickly gives in to make both their bad feelings disappear.

When there are no limits or when the child has too much power or control, she may become frightened (often unconsciously) with being given so much sway over a parent. Feelings of safety and being taken care of are compromised when the caretakers are not in control. Without a safe base growing up, independent actions and thoughts become risky, impeding the process of separation/individuation.

2. Dependency: Difficulties in future relationships are likely as Molly has not learned to self-regulate and has come to rely on significant others to maintain her positive emotional equilibrium, often at the cost of not knowing her own mind.

Relationships are dominated by the need to avoid intolerable feelings. In order to guarantee that others are pleased and no one has unwanted feelings, consideration and knowledge of what one wants is surrendered to others. There is a need to be agreeable, have no differing or opposing thoughts and feelings, and, in general, control the feelings of others to ensure everyone’s happy, satisfied feelings. This creates dependence on others for reassurance and approval of wishes, desires, and choices.

Anxiety About Anxiety

When one is deprived of learning to cope with uncomfortable feelings, it is likely that compensatory strategies for dealing with discomfort with others are developed. Relationships must be constructed to elicit positive reactions and avoid creating unwanted feelings. This limits relational possibilities and requires (consciously and unconsciously) the concealing of one’s authentic thoughts and feelings. In situations where the upset is so unbearable, the need to protect oneself may require hiding these feelings from one’s own conscious awareness, causing dissociation in the service of managing the feelings that emerge in interaction with others.

The dilemma of how to stay anxiety-free may lead Molly to become dependent on her mother for assurances that her life decisions are acceptable and will not create anxiety for either one. If she hands over this process to her mother, she will not develop the ability to regulate her own feelings and she will deprive herself of developing an identity separate from her mother: who she is and what she wants will be determined by the guideline of safety first—no intolerable feelings, not for Molly and not for her mother. It can become unclear who is taking care of whom. If Molly begins to feel trapped by this situation, she may also choose to deal with her discomfort and her mother’s anxiety by detaching from or rejecting her mother. For Molly, both dissociation and detachment would result in disconnection from herself.

Isabel could also deal with her anxiety by dissociating or detaching from Molly. This implies that, for the most part, her feelings about Molly would be largely on hold. While a parent could unconsciously solve the anxiety dance by unconsciously opting to anesthetize themselves, it is hard to imagine that Isabel would, under any circumstances, become so emotionally disconnected from Molly.

Isabel and I have been working on a strategy that requires conscious cooperation with herself. We have been talking about how she can reframe her “bad mother” thoughts to understand that allowing Molly to have her uncomfortable feelings is an act of good mothering that enables Molly to develop the skills to regulate her own feelings. Isabel intellectually understands that she and Molly need to be less dependent on each other for maintaining comfortable feeling states. She also recognizes she is in a symbiotic relationship with Molly that keeps Molly from being able to reflect about her own life and learn about her own wants and needs.

It is painful for Isabel to move beyond her intellectual understanding of her impact on Molly:

“I just don’t know if I can get there. I want to be able to feel like a good mother when I stand by and don’t soothe and reassure Molly. But it’s scary when I’m aware I did something that upsets her and I don’t jump in and make it okay. I’ve been trying, and she seems more anxious and she gets angry at me, which is horrible. I keep telling myself that she has to learn that she can take care of her own feelings. I tell myself she is not responsible to make me feel good. I tell myself over and over. I’m beginning to hear myself, but it’s so, so, so hard to listen to myself. But I do know I have to do this for Molly, even if it seems I’m hurting her. I hope you will stay with me while I keep trying.”

I will.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.