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.

Pursuing psychotherapy is a brave endeavor indeed. Many people make this choice when they find themselves in a dark place and are unable to see any light ahead of them.

In order to even begin the process of finding a therapist, you may first have to confront societal and internal judgments (“I must be sick.” “What’s wrong with me that I need to do this?” and so on). After that, you then find yourself attempting to choose a complete stranger who you will entrust with your innermost thoughts. If you haven’t sought therapy before, you may feel overwhelmed and as if you are stepping into the unknown. You might feel anxious or afraid and be unsure of the best way to proceed.

If you are experiencing serious distress, you may have gone as far as you can by yourself, or with the support of friends and family, and done as much as possible in order to improve on your own. You may feel as if you have no further choice beyond therapy.

Whatever your reasons for choosing therapy, however you get to the therapy office, I have a tremendous faith in the psychotherapeutic process. When a therapist and the person seeking help can earnestly work together to explore the person’s inner world, utilizing the contact made between the two of them (the therapeutic relationship), greater insight and an increased ability to address and work through inner conflicts is likely, and maturation often follows.

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I don’t think that every therapy process is successful, however. A number of unconscious forces may be at work, in either the person seeking help or the therapist attempting to help them, and any of these might effectively derail therapy.

Keeping the following eight points in mind, from the time you begin therapy and throughout the process, may help you make the best of your choice to seek help—and get the most out of your therapy sessions.

1. Therapy starts when you decide to seek therapy.

Take your search for a therapist seriously. Try to get a few names of potential therapists you can then interview. Taking the time to be thorough and control your search better enables you to find the therapist who fits you best, not only with regard to the specific issues bringing you to therapy, but also with regard to your personality and identity.

Some mental health professionals offer a first consultation over the phone, free of charge. Take advantage of this, if possible. You may be able to get a feel for their manner and personality, and at the very least, rule out some who may not be ideal for you and your needs.

2. Allow yourself the time to assess the fit of your therapist.

If you are in distress, you may be anxious to begin therapy and alleviate some of what you are struggling with. This is a common feeling. You might want to just choose a therapist at random and fall right into the process of therapy. While this can work for some people, it is often best to consider the first few sessions as a mutual assessment and use them to get a felt sense of whether this therapist not only listens, but hears what you have to say, and if this is a helping professional you feel comfortable with. Doing so is likely to greatly increase the chances for a good therapeutic alliance and eventually, success with treatment.

That being said, listen to your gut. If something doesn’t feel right, it’s generally best to move on in your search.

3. Take some time in the beginning to think about your goals for therapy.

Although therapy can take unexpected twists and turns, you can establish a more definitive direction to continue to assess the therapy if you establish goals in the beginning and keep these in mind throughout your work with a therapist. Goals might include minimizing painful symptoms, gaining insight, or pursuing transformation, among others. Regardless of what goals look like for you, they can often serve as a guide when therapy seems aimless.

Regardless of the number of therapy sessions you attend each week, you can maximize the benefits of treatment if you take the time to reflect on what you talked about in the session and—even more importantly—what you felt during and after each session.

4. Share your doubts, fears, concerns, and hopes.

You might be surprised to learn many people don’t share their doubts, fears, concerns, or even hopes with their therapist, perhaps because doing so might feel scary. But I say it can be well worth the risk! These feelings are deep expressions of you, and they can help your therapist know your particular vulnerabilities and become more informed about what you need from your therapy.

If your therapist reacts negatively to these feelings, this is often a red flag they might not be a good fit for your needs.

5. Talk to others who are receiving or have received “good” therapies.

It can be helpful to talk to friends or family members who have had a positive therapy experience. It’s possible to discuss this without exchanging details that may be too personal or private. You might simply ask what helped them most in their experience, or what detail(s) made their therapist a good fit. Although every therapeutic relationship will be unique, there are some universal aspects of good therapy you can look for.

6. If you don’t like something your therapist says, tell them. If you really like something your therapist says, tell them.

It is very possible that, if you are suffering or experiencing distress as an adult, your injuries were originally sustained within the context of your early relationships with caretakers. Thus, opportunities for healing are often greatest within the context of a relationship. Because of this, it is important to share feelings of hurt, anger, or disappointment, along with more positive feelings, with your therapist. This feedback is helpful, and can be essential, as it helps your therapist get to know you better and gain greater understanding of what you need from therapy.

7. Try to reflect on each session in between sessions. Share those thoughts with your therapist.

Regardless of the number of therapy sessions you attend each week, you can maximize the benefits of treatment if you take the time to reflect on what you talked about in the session and—even more importantly—what you felt during and after each session. These feelings often communicate something important about what is happening on an unconscious level during the therapy process.

8. Reflect on your goals from time to time during the therapy.

Use your goals as signposts from time to time. Beyond simply keeping them in mind, take the time to really consider them. Checking in on how things are going, with yourself and with the therapist, can be helpful. Doing so can allow you to recalibrate with your therapist, if necessary, in order to stay on course.

Therapy can be a lengthy process. It may be difficult at times, but keeping these tips in mind can help you increase your chances of success and make it more likely you will find the challenge of seeking treatment to be a rewarding one. Therapy can work for you, as much as you work for it.

I wish you the best in your therapeutic endeavors.