Module Seven: Analyzing Emotions

Abstract

When we are under stress, the amygdala initiates the release of stress hormones into our brain. These stress hormones can weaken areas in the brain including the prefrontal cortex and the hippocampus, which play important roles in the analysis of emotions. If we fail to analyze and understand the reasons for our present emotions, we may feel confused and out of control. This will likely lead to increased activation in the amygdala and the release of additional stress hormones that will make it even more difficult to analyze the emotions. This vicious cycle can be prevented or interrupted with ART Skill #6—Analyzing Emotions.

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

1 Vicious Cycle #6: Amygdala Activation and Difficulty Analyzing Emotions

Slide 74: We will now discuss yet another vicious cycle that maintains negative emotions. When we are under stress, the amygdala initiates the release of stress hormones into our brain and body. These stress hormones strengthen amygdala functioning but weaken other areas in the brain including the prefrontal cortex and the hippocampus, which play important roles in the analysis of what cued our emotions. The ability to analyze and understand why we feel the way we do provides a sense of mastery and control that reduces activation in the amygdala.

If, through weakened prefrontal and hippocampal functioning, we lose our ability to analyze our emotions, we will probably feel confused and out of control. A vicious cycle now develops, since feeling confused and out of control unfortunately triggers the amygdala to sound the danger alarm even louder. Now even more stress hormones are released and the vicious cycle is repeated as the stress hormones further weaken prefrontal and hippocampal functioning and increase amygdala activation.

2 ART Skill #6: Analyzing Emotions

Slide 75: We can prevent or break this vicious cycle by analyzing our emotions during times of distress. By analyzing our negative emotions we gain a better understanding of why we feel the way we do. This knowledge reassures us that we are in control of our emotions, which calms the amygdala activation and facilitates effective emotion regulation.

Slide 76: The good news is that we can practice the ability to analyze and understand our emotions. ART Skill #6—Analyzing Emotions—consists of a series of steps we can take to better understand how and why we feel the way we do. These steps can be practiced until we are able to conduct an analysis of our emotions, almost automatically, even during times of stress.

Before we get into the specific steps of analyzing our emotions, we are going to do an exercise to help us look at our emotions from a different angle. Let’s start the exercise by thinking of a negative emotion that we had in the past week. I am going to ask you to draw this emotion in any way that feels best for you. Any way you would like to express the emotion through drawing is fine. After everyone is finished, we are going to discuss the drawings. If some of you feel anxious about this exercise because you believe you are not good at drawing, please bear in mind that the intention of this exercise is definitely not to produce an art masterpiece! Instead, it is an opportunity for your mind to express an emotion in a unique way. We will have about 15 min to work on these drawings.

Note to the therapist:

At this point, the therapist passes out a piece of flip chart paper to each participant. Colored pencils, crayons, markers, colored chalk, and watercolor paints should be made available to use. It may be helpful to play music that is relaxing or that fosters other positive emotions in order to inspire creativity and reduce anxiety regarding the exercise.

After 15–30 min, the participants take turns presenting their work. As the participants present their drawings, the therapist helps them understand the emotions represented in the drawings by asking questions and making observations, similar to what a therapist would do during a psychotherapy session utilizing art therapy. While the participants are presenting their pictures, the therapist also uses the drawings to illustrate concepts that are important for analyzing emotions. These concepts, listed below, will later be incorporated into a step-by-step process for analyzing emotions that will be explained to the participants:

• Challenging situations normally trigger more than one “negative” emotion. However, since it is difficult to analyze more than one emotion at a time, it is important to be aware of the various emotions we are experiencing but pick only one at a time to analyze. As the participants present their drawings to the group, the ART therapist may say, “So, this drawing represents the anger you feel when your boss makes unreasonable demands on you, as well as fear about what could happen if you talk back to your boss. This is a good example of how we often experience several emotions simultaneously. Since it is impossible to analyze different emotions at the same time, the first step when analyzing emotions is to decide which emotion we want to analyze first. After we choose an emotion and analyze it, we can then pick another one and analyze it as well. Which emotion would you like to focus on now as we talk about your picture?”

• Our emotions are often triggered by specific events, circumstances or situations. “So this section of your drawing here shows your boss telling you that you must work double-shifts for 2 weeks? Is your boss’ statement the specific part of this situation that led you to become really angry?”

• Our emotions are influenced by our current physical and emotional state. “It sounds like you were feeling tired and on-edge just before this interaction with your boss. I wonder if that made this situation even more difficult.”

• Our emotions are determined by how we appraise situations. “So at the time you believed you were being forced to do something you did not want to do. You felt this was not fair and that he was not being considerate of your needs. Did I get this right?”

• Our appraisals are determined by how our needs, wishes, and goals are impacted by a situation. “It sounds like you were concerned at the time that your boss’ demand to work double-shifts would prevent you from important things you had planned to do, such as spending time with friends and family. Is that what was at stake in this situation?”

• Our emotional response can be influenced by how we have reacted to past situations in a similar manner. “It sounds like you have felt angry in the past during similar situations. So, do you think this emotional response that you are describing is repeating an old pattern? If so, what could you call this pattern?”

• The primary emotional response can also be appraised and trigger secondary emotions. “It seems as though in this situation you thought you should not be angry and consequently you were angry at yourself for being angry. Correct? How did this affect your primary or initial feelings of anger? Okay, I see that it made them even worse.”

• Specific body sensations accompany emotions. “Did you notice any changes in your body (e.g., heart racing, faster breathing, etc.) when you became angry?”

• Emotions can compel us to engage in various behaviors. “What did the anger tell you to do? Oh … I see. You felt like punching your boss in the face.”

• While our emotions can compel us to engage in various behaviors, we always retain the option of choosing actions that are different than the actions that our emotions compel us to do. “So you felt like punching your boss … and what did you actually do? I see … you agreed to work the double-shifts? And what did you do with all the energy from the anger?”

Since the participants’ exploration of emotions in front of the group is likely to elicit feelings of vulnerability, the therapist should work to provide support and validation to foster a sense of safety and control during the next exercise. The therapist then passes out copies of the Analyzing Emotions Worksheet (Appendix Q) to the participants. This worksheet outlines a step-by-step process to analyze emotions and incorporates the concepts that were just explained.

The therapist continues speaking to the participants:

Slide 77: This worksheet will be our guide for thoroughly understanding how and why we feel the way we do. If you are thinking, “This sure is complex!” you are correct. It is! Emotions are complicated things, but don’t worry, we will get through this together. No one expects you to have this whole thing mastered today. We will look at this worksheet together and go through it step-by-step, and eventually you will understand the concept. In order to practice going through the steps on the worksheet, we will work right now with the emotion “anxiety” that has resulted from a hypothetical situation that happened to us at work. In this situation our boss told us to increase our sales numbers by 10 %.

Okay, here we go. To start with, we need to remember that we can only analyze one emotion at a time. This means that the first step in analyzing an emotion is to be aware of the different emotions we are experiencing and then to decide which specific one we would like to analyze. Using our hypothetical situation at work, we may have felt a mixture of fear, anger, and anxiety. Since we cannot analyze all of these different emotions at once, I will choose “anxiety” to analyze. So I would write “anxiety” in Box #1 on the Analyzing Emotions Worksheet.

Then, I determine what situation triggered the emotion. This should only include the facts of what occurred. “My boss told me to increase my sales numbers by 10 %.” Be careful not to include opinions or interpretations of what occurred. So for Box #2, I would write the objective facts of what occurred such as “told to increase sales by 10 %.”

I next look at how I felt, both emotionally and physically, just before I experienced the anxiety, since our emotional vulnerability often plays a role in our reactions. For example, at the time that my boss told me to increase my sales numbers, I may have been fighting a cold or had been in a heated argument with my spouse earlier that morning. These types of emotional and physical states can cause us to view difficult situations more negatively than we would if we were healthy and happy at the time. For Box #3, I would describe my physical and emotional state at the time. For example, I could write in Box #3 that “I was already irritated from an earlier argument with my spouse,” or “I was fighting a cold at the time.”

The next step is to examine how I appraised the situation. This can be broken down by asking three questions:

• 1. What did I focus my attention on during the situation?

• 2. How did I interpret the thing that caught my attention?

• 3. How did I evaluate the overall situation based on how I interpreted the thing that caught my attention?

Note to the therapist:

The second question asks “How did I interpret the thing that caught my attention?” Interpretation involves at least three components that should be mentioned because each component can be a target for cognitive interventions. First, interpretation involves labeling or categorizing the situation (e.g., serious health problem). Second, interpretation involves attributing the situation to an assumed cause (e.g., because of the stress I am under). Third, interpretation involves a prediction of what will happen next in the situation (e.g., I will never get well again). Unhelpful cognitions in any of these three components of interpretation can lead to dysfunctional affective responses.

The therapist continues speaking to the participants:

For example, as my boss told me to increase my sales numbers, I could have focused on the irritated tone in his voice. Maybe I interpreted his irritated tone of voice as a signal of his displeasure with my overall performance. Since I believed at the time that he viewed my overall job performance poorly, I evaluated this interaction with my boss negatively. In Box #4, I would write down my appraisal of the situation. More specifically, I would write (1) what caught my attention (e.g., boss’ irritated tone of voice), (2) how I interpreted the situation (“My boss thinks I am a bad employee!)”, and (3) my evaluation of the overall situation—“This is awful!”

The evaluation of a situation has a crucial impact on our emotions. As soon as we evaluate something, we generate an emotion. If we evaluate something as negative, we generate a negative emotion. If we evaluate something as positive, we generate a positive emotion. Situations are not inherently “good” or “bad.” Instead, we evaluate situations as good or bad according to how a situation either facilitates or hinders the attainment of goals that are important to us.

Using our example, if my boss demands increased sales numbers, I might believe that I may be fired soon. If I am the sole provider of income for my family of five and my primary goal is to create financial security for my family, the possibility I could be fired would probably cause me to feel anxious. In this case, I would write down my goal that is being threatened, “ensure financial security for my family” in Box #5. On the other hand, if I am unhappy because I hate my job, I have plenty of money saved up, and my goal is “to have more time for myself,” then the possibility that I may be fired could actually bring relief instead of anxiety. This example illustrates the point that the type of goals we have impact how we feel about various situations. Therefore, it is important to identify the goals that are related to the emotion we are analyzing.

In the next step, we explore the possibility that our response to this situation is similar to how we have typically responded in the past in similar situations. This old response pattern could consist of thoughts, emotions, and behaviors that we have consistently used in the past. If we believe that our present response to this current situation is part of an old response pattern, we try to label it and then write the label in Box #6. For example, using our hypothetical scenario at work, I may realize that my anxiety in this situation is related to an old response pattern to difficult situations in which I typically believe, “Bad things are going to happen to me!” I could use this thought to label my old response pattern and write, “Bad things are going to happen to me!” in Box #6.

It is important to remember that not every response to a situation is based on an old response pattern, so in these cases, Box #6 would simply be left blank. While old response patterns will not be relevant for every situation, this is still an important step to explore. The identification of an old response pattern can provide a sense of understanding and order when our own responses feel confusing and disorganized. The awareness of these patterns also provides us with ways that we can positively intervene in these types of situations. (For further information on contributing elements of response patterns, refer to Beck, 1964, 1995; Ellis, 1977; and Young, Klosko, & Weishaar, 2003).

After we look for old response patterns that may be contributing to our current reactions, we look at how the emotion manifests itself in our body, such as increased heart rate and respiration. This is an important step in the analysis process since many physical complaints are related to emotional responses. In these cases, the physical symptoms will persist unless the emotion is effectively regulated. In Box #7 we describe how and where the emotion is experienced in the body, such as “tightness in my chest and a pit in my stomach.” (The therapist is encouraged to review Appendix J and Appendix K for examples of physical manifestations of emotions.)

In the next step, we identify the emotions that were triggered as we evaluated our emotional state. The human brain tends to evaluate significant experiences. Since intense emotions feel significant, they are very likely to be evaluated. As we have said before, “Every evaluation triggers an emotion.” Thus, assigning a negative evaluation to a challenging emotion will inevitably trigger a “secondary” challenging emotion.

We can identify secondary emotions by asking “How do I feel about my emotional reaction?” Examples of common secondary emotions include feeling helpless about being anxious or feeling shame for becoming angry. So in Box #8, I would write something like “felt hopeless about being anxious.” Since negative secondary emotions hinder efforts to regulate the initial emotional response (see Greenberg, 2002), it is important to identify and eventually learn to reduce negative secondary emotions.

The next step in this process is to identify the urges or impulses to act that are triggered by our emotional response. These urges can be viewed as knee-jerk reactions. For example, my impulse in the hypothetical scenario may have been to “work through the night, so I could increase my sales numbers,” which I would write in Box #9. Just because we have an impulsive urge to do something does not mean that we must carry it out. This is the point at which we are able to choose either to follow our impulse or to act differently. For example, although my impulse in the hypothetical scenario may have been to “work through the night, so I could increase my sales numbers,” I actually chose to go home at 11 pm. I would write my actual behavior “going home at 11 pm” in Box #10.

Finally, it is important to consider the short- and long-term advantages and disadvantages of my emotional response. This is important information we can use to decide whether and how we want to modify our emotion. Using our current example, a short-term advantage of my anxiety could be that it motivates me to stay more focused at work, which in the long-term could help me keep my job. I would list these short- and long-term advantages in Box #11. On the other hand, a short-term disadvantage could be that anxiety causes me to miss having dinner with my family. A long-term disadvantage could be that anxiety causes me to end up hating my job. I would write these short- and long-term disadvantages of my emotional response in Box #12.

Note to the therapist:

After describing the steps of the Analyzing Emotions Worksheet (Appendix Q), the participants are given an opportunity to ask questions about the analysis process. The therapist should explain that with practice, they will be able to learn the steps in this analysis process and apply them to their emotions in real time.

The therapist then invites one of the participants to share a personally challenging emotion, which the participants can use as a group to practice the steps of the Analyzing Emotions Worksheet. Using the participant’s example, the therapist works collaboratively with all of the participants to work through each step of the worksheet. The therapist records the participants’ responses in the boxes that correspond to each step of the worksheet on a large poster-board-size version of the Analyzing Emotions Worksheet. If this enlarged copy of the worksheet is laminated, the therapist can use dry-erase markers to record the participants’ responses. The laminated worksheet can be erased and reused during future training sessions.

Next, the participants are asked to use the Analyzing Emotions Worksheet to analyze one of the important negative emotions they depicted in the drawing they made earlier. They should write the information related to each step of the analysis process in the various boxes on the worksheet. After they complete the worksheet, they may discuss it in pairs. The therapist should spend a few minutes working with each pair to provide support and to clarify any questions they may have. When the pairs have finished reviewing their worksheets, the therapist may either elect to ask individual participants to present their Analyzing Emotions Worksheet to the group or choose instead to offer some time for the participants to ask questions or make comments about the worksheet.

It should be noted that the steps listed in the Analyzing Emotions Worksheet can be modified or simplified in order to make it easier to use. For example, if a participant has difficulty with Box #4 (Attention, Interpretation, and Evaluation), the therapist may instead ask the participant to simply say what “thoughts” crossed his/her mind during the situation that triggered the emotion. The therapist can then use these thoughts to help the participant discover what goals were threatened by this situation (Box #5).

As the participants learn the process of analyzing emotions, the therapist should be sure to provide sufficient empathy and support to each participant. For example, if a participant has difficulty determining how and where he experienced the emotion in his body (Box #7), the therapist might say, “It seems as though it is hard to locate where this feeling is located in your body. It sure is tough to figure out how emotions manifest in our bodies. Sometimes it can help if you visualize the situation for a moment. Do you have it? Good! Now focus your attention to your body. What changes do you notice in your body?”

While helping participants to understand and analyze their emotions, it is also important to normalize the difficult nature of this process. The participants should be reminded that, as they are learning to analyze their emotions, it is fine if they do not have answers for each and every box on the worksheet. With time and practice they should feel more and more confident with the steps involved in analyzing their emotions.

3 ART Sequence with ART Skills #1–6

At this time, ART Skill #6 is integrated into the ART Sequence.

The therapist continues speaking to the participants:

Slide 78: We will now include ART Skill #6 into the ART Sequence. During the last several ART Sequence Exercises, we tensed several specific muscles together at one time and then relaxed them. Starting with this next ART Sequence Exercise we will shorten the muscle relaxation technique even further by consciously relaxing specific muscles without tensing them first. Does anyone have questions about this change?

The therapist may guide the ART Sequence Exercise using the “Exercise Six” audio that can be downloaded from the ART website, or the therapist may guide the exercise using the following instructions:

We will start the exercise after the sound of the bell.

Sound of the bell

Find a comfortable position. Close your eyes. Allow your body to relax as much as possible. Focus your attention on your muscles. Breathe in … and out. As you exhale, relax the muscles in your hands … forearms … upper arms … face … neck … shoulders … back … belly … buttocks … and legs. (slight pause) Now focus your attention on your breathing. Breathe in … and out. With each exhale, allow your muscles to relax even more. (5 s pause)

Now, shift into the state of nonjudgmental awareness by observing your breath without trying to control it. (5 s pause) Simply notice how it feels when you breathe in and out. (5 s pause) Now prepare to broaden the focus of your attention. Remember that when you realize you’re getting distracted or that thoughts are crossing your mind, use a word to label what is happening, such as “planning,” “worrying,” or “remembering,” and then gently refocus your attention. Be aware of any sensations in your body (5 s pause), any sounds you can hear (5 s pause), or any odors you can smell. (5 s pause) Notice what you can see even though your eyelids are closed. Maybe you see patterns or maybe you notice lighter and darker areas. (5 s pause) Notice what thoughts are coming into your mind … (5 s pause) what needs, desires, goals, or impulses to act are currently activated in your mind. (5 s pause) Notice what emotions or moods you are currently experiencing. (5 s pause) Briefly label these feelings. (5 s pause) Rate the intensity of your feelings on a scale from 0 to 10. Be aware of the places where you feel these emotions in your body. (10 s pause)

Now take a moment to develop an Acceptance and Tolerance Statement for a negative emotion that you have become aware of presently or one that has been challenging for you in the past. For example, you might say something to yourself like “It’s okay that I feel this way. These feelings are an important part of me, and they are trying to help me by providing me with valuable information. I can tolerate them for now because I know they won’t last forever.” (1 min pause)

We will now begin to shift our focus onto fostering compassionate self-support. Begin by imagining a situation that was difficult for you in the past or something more recently, some situation in which you experienced negative emotions. Now do your best to visualize that you are observing yourself from above this scene. (5 s pause) What do you see as you are looking down at this scene? (brief pause) Where are you? (brief pause) What is happening that is triggering your negative emotions? (brief pause) Which negative emotions are you experiencing? (brief pause) How are your negative emotions reflected in your body posture, facial expression, tone of voice, etc.? (5 s pause)

Now do your best to let the feeling of compassion toward yourself arise within you … a strong and warm feeling of empathy for yourself that is accompanied by the desire to help yourself and a desire to end your suffering. (5 s pause) Visualize yourself entering this scene as well, and approach yourself, who is in some way hurting in this scene. (5 s pause) Communicate to yourself that this is a difficult situation. Normalize the negative emotions, and provide reassurance by saying that you are there to support and comfort yourself (not to give advice). (10 s pause) If it seems appropriate, visualize giving yourself a physical gesture of compassion (e.g., laying a hand on your shoulder or giving yourself a hug). (10 s pause) Provide encouragement to yourself. Maybe you could say something like, “You’ve gone through a lot in the past, and you can get through this too! I’ll be with you as you work through this. We will get through this together!” (10 s pause) Give yourself a big, kind, reassuring smile. (5 s pause)

Now, let’s practice the skill of analyzing a negative emotion. Maybe you would like to analyze a negative emotion that was triggered in the scene you just visualized. Maybe you would like to analyze a negative emotion from a situation in the past or even one you are currently experiencing. Select a feeling that you want to analyze. (10 s pause) I will guide you through the analysis process by suggesting a series of questions that you can ask yourself based on the worksheet we just completed. Imagine that you are asking these questions of the part of you that is experiencing challenging emotions. Try to give your attention to each question.

First, what situation prompted this feeling? (10 s pause) Did a particular emotional or physical state leave you vulnerable to this emotional reaction? (10 s pause) What in particular caught your attention about the situation that triggered the emotion? (10 s pause) Also, how did you interpret and evaluate the situation? (10 s pause) Which needs, goals, desires, or expectations were associated with this interpretation and evaluation? In other words, what was at stake in this situation? (10 s pause) Was your interpretation and evaluation related to ways you have commonly responded in the past during similar situations? What label could you give to these old response patterns? (10 s pause) How do you feel about having this emotion? (10 s pause) How and where do you feel this emotion in your body? (10 s pause) Do these body sensations cause the emotion to last longer or feel more intense? (10 s pause) What impulses to act are triggered by the emotion? (10 s pause) If you have already acted on these impulses, what did you end up doing? (10 s pause) What are the short-term and long-term advantages of this emotion? (10 s pause) What are the short-term and long-term disadvantages of this emotion? (10 s pause) Take some time now to review and reflect on what you have discovered in the analysis process. (30 s pause)

Now, at your own pace, bring your attention back to this room. Allow your muscles to relax. Take a deep breath, and on the exhale, allow your muscles to relax even further. (5 s pause) You may keep your eyes closed, as we continue on, shifting our focus onto a positive experience in order to foster feelings of joy. Start by imagining a situation from the past week that was pleasant for you. Pick any pleasant situation. It does not have to be some extremely euphoric experience. Any slightly positive feeling is fine. (10 s pause)

Once you have remembered a situation involving a pleasant experience, imagine you are floating above this scene observing yourself. As the observer, notice how the positive emotions are expressed as joy in your facial expression and body posture. (10 s pause) As the observer, allow this joy to arise within yourself leading to “sympathetic joy” or a feeling of happiness that you are seeing yourself happy in this scene. (10 s pause) Allow the possibility that feelings of gratitude for this joy may arise within you. (10 s pause)

Now imagine that you enter this visualized scene. Consider telling yourself that you are happy for the positive emotions you have experienced in this scene. (10 s pause) Ask yourself to consider which of your strengths and abilities contributed to these positive feelings. Maybe it was your courage to try something new that led to these positive feelings. You may want to say to yourself, “My wish for you is that you may be able to appreciate positive feelings and use the energy from these feelings to overcome difficulties and challenges in life.” (10 s pause) Now try to give yourself another big, kind, reassuring smile. Maybe there is something you want to say to yourself before you go. If so, feel free to do so now. (10 s pause)

When you are ready, say goodbye to yourself. (10 s pause) Now, at your own pace, slowly begin bringing your attention to your body again. Bring your attention to your breathing. Notice how the breath flows in and out. (brief pause) Now bring your attention from this exercise into the present moment. Stretch your body. Open your eyes, and return to the present experience of being in this room.

Sound of the bell

As usual, a debriefing occurs at the end of the exercise.