“The beginning of wisdom is the ability to call things by their proper names.”
“How does that make you feel?” is a clichéd therapy question that sort of sticks in my throat. It makes me feel… yucky.
I’m not saying that’s a reasonable response. I’m just being honest.
I think it’s because feelings, if not regulated, can become all there is.
Sometimes we need to think, intuit, and act. To get too bogged down in feelings at the expense of those other parts of humanity can lead us into an orgy of perspective-losing, self-absorbed, humourless paralysis by analysis.
It’s a favourite staple of news correspondents and interviewers too. A mic is thrust hungrily into the face of some poor victim of an natural or unnatural disaster, and the cliché flows forth:
“How does that make you feel?” … to which two replies would be apt:
A: “Just wonderful!” (the ironic answer)
B: “How the BLEEPING BLEEP do you BLEEPING think it makes me feel?!”
I think perhaps it – the question in question – gets wheeled out when people don’t know what else to ask. A sort of desperate therapeutic fallback position… and actually, that may be the root of my distrust of the question. And yet it’s something I need to get over.
Because despite the perhaps injudicious use of the “how does that make you feel” question, it is valuable sometimes. And I certainly use it myself – I hope not overly!
Spotting and naming feelings, especially for those who aren’t necessarily that good at knowing how they feel, can be hugely valuable as a first step to regulating emotions. And if we use the question well and teach others how to recognize how they feel more precisely when it matters, it may even guard against depression.
Getting to know thyself
Good emotional intelligence partly depends on recognizing what we are feeling. We can’t deal with what we don’t understand. Only when we objectively understand the true nature of what we’re feeling can we avoid denial or projection.
Say I’m envious of you because you’ve just got a huge raise. If I name that feeling, I have a chance to do something with it.
Recognizing our true feelings isn’t always pleasant or self-flattering! But if I don’t recognize the cause of my grumpiness is envy, or if I deny to myself my envy, then all I know is I feel bad about something… and it’s hard to do anything particularly useful about that!
What I may do, because I don’t want to see such a mean-spirited feeling in myself, is project outward to someone else, perhaps manufacturing in them some deficit that I convince myself has really caused my ire. So I rationalize and justify, but step away from the truth.
That way lies the temporarily comfortable but ultimately destructive path to denial and cognitive dissonance.
Now this is all very good in theory… but what evidence is there of the importance of being able to register and name our feelings?
The value of precisely recognizing feelings
Research has found that understanding how you feel, and being able to describe it, may protect against depression.1
In this study, 233 adolescents were asked to report their emotions four times a day for a week. Eighteen months later, those who had monitored their feelings and named them were found to be better at differentiating their emotions and less likely to be depressed than those who were not so good at delineating between, say, being annoyed or ashamed or frustrated or sad. Further, those young people who could describe their emotions precisely were better able to deal with stressful life events.
In other words, the study found that differentiating our emotions helps us regulate our feelings better.
So, for example, rather than just telling ourselves, “I feel bad!”, we can pinpoint our emotions more accurately – we can recognize “I feel frustrated!” or “I feel disappointed” and so on.
So the simple question that may help protect against depression is: “How do I really feel?”
“I feel crap!” isn’t good enough. “I feel sad” or “I feel resentful” is more specific. And once we pinpoint our specific feelings, we may even find a specific cause for those feelings – which can lead to solutions, or at least reframes.
The lead author of the study, Dr Lisa Starr, said, “Adolescents who use more granular terms such as ‘I feel annoyed,’ or ‘I feel frustrated,’ or ‘I feel ashamed’ – instead of simply saying ‘I feel bad’ – are better protected against developing increased depressive symptoms after experiencing a stressful life event.”
The researchers talked of NED – no, not one of the research subjects! NED stands for negative emotion differentiation.
Again from the lead researcher:
“I believe that NED could be modifiable, and I think it’s something that could be directly addressed with treatment protocols that target NED. Our data suggests that if you are able to increase people’s NED then you should be able to buffer them against stressful experiences and the depressogenic effect of stress.”
Basically, if we can name our feelings accurately, we can do something about them. In order to change the way you feel, you need to first recognize the way you feel.
Dr Starr also said:
“Emotions convey a lot of information.They communicate information about the person’s motivational state, level of arousal, emotional valence, and appraisals of the threatening experience. A person has to integrate all that information to figure out – ‘am I feeling irritated’, or ‘am I feeling angry, embarrassed, or some other emotion?’
“It’s going to help me predict how my emotional experience will unfold, and how I can best regulate these emotions to make myself feel better.”
How negative emotion differentiation helps
So despite my visceral reaction to the overuse of the “how do you feel?” question, helping our clients recognize how they really and specifically feel about something can do three vitally important things:
- Increase emotional awareness and regulation,
- Facilitate communication, and
- Promote emotional processing and healing.
NED increases emotional awareness and regulation
When we are aware of our emotions, we can regulate them more effectively. Naming emotions can also help clients understand the intensity of their feelings and identify the source of their emotional experiences. This process can help them make sense of their emotions and respond to them in healthy ways.
In a 1990 study, participants who received training in recognizing and naming their emotions showed better emotional awareness and regulation.2 The researchers found that this training improved their ability to manage negative emotions and increased their sense of control over their emotional experiences. This older study foreshadowed the more recent research I mentioned above.
NED facilitates communication
Naming emotions can also facilitate communication, both with oneself and with others. When we can put a name to our emotions, we can more easily express them to others. This can help us connect with others and foster more meaningful relationships. Additionally, identifying and labelling emotions can help individuals communicate with themselves, increasing their self-awareness and self-understanding.
Research has shown that naming emotions facilitates communication in therapy.3 It was found that clients who were able to identify and express their emotions more effectively had better therapeutic outcomes.
NED promotes emotional processing and healing
When individuals are able to identify and express their emotions, they can begin to explore their emotional experiences and the events that led to them. This process can help them make sense of their emotions and move towards healing and resolution.
The capacity to differentiate clearly between negative states we are feeling, rather than just “I feel crap!” may also help people avoid maladaptive, risky behaviours – which is why it’s such a great skill to teach teenagers, I’d imagine!
In one piece of research it was found that multiple sclerosis patients who were taught NED were more likely to adhere to their medication protocol.4 So there may even be a safety benefit to recognizing what we feel more precisely!
Okay, okay, I take it all back! “How does that make you feel?” can be a highly valuable question! (Assuming it’s not just blurted out in an imprecise, knee-jerk fashion!)
But how might we ask questions that actually help clients improve their negative emotion differentiation?
Tip one: Use incisive questioning
When asking our clients how they feel about something, we can do so incisively. What does this mean? Well, for example, if they tell us they feel “terrible” or “lousy”, we can ask them to specify what they mean by that. It’s not that we don’t accept the feeling, or automatically assume they are wrong or in denial or something. But we can gently ask them to specify.
So if they say, “It makes me feel lousy,” we might counter with, “Just to be clear in my mind, when you say ‘lousy’, do you mean physically unwell or emotionally upset?”
So we begin to whittle it down and help them with their NED, to use the researchers’ acronym.
If they still struggle to pinpoint the feeling, we can go further.
Tip two: Give them choices
Recently I worked with a less than loquacious teenage boy. I asked him what he felt about his girlfriend having ended their relationship a few days before.
“I don’t know! I guess I feel sh*t about it!”
So I asked, “When you say “sh*t, Paul, do you mean: sad, angry, disappointed, shocked, or something else?” So I gave him a set of choices from which to pick a more delineated feeling.
He replied, as I thought he might, “Yeah, all of that.”
So I wrote those feelings down and asked him to rank them in order of the most felt emotion to the least. He ranked angry as number one, shocked as number two, and so on, with sad actually ranking the lowest. We were starting to get to the nub of it. He seemed to find this fascinating and even surprising, but confirmed that this was genuinely how he felt.
As a caveat, we need to avoid leading our clients when we offer them suggestions as a way of helping differentiate better. I often add “or none of those?” or “or something else?”
I asked him what percentage of his feelings might be anger and, after reflecting for a while, he said a full 90%!
I suggested that anger often fades quite quickly and may be partially replaced with another feeling after a while. Or, more likely, all the feelings around a situation fade with time. We now had something to work on.
As a behavioural version of the “how does that make you feel” question, we can ask our clients to do something else.
Tip three: Ask your client to keep a NED journal
You could also task clients with naming their feelings in a journal four times a day, just as the researcher in the first study I mentioned did.
You could ask them to be as specific as possible and also add any possible causes of the feelings they’ve spotted. It’s not that we want our clients to become obsessively self-referential or overly conscious of their feelings all the time, as that makes for a clunky and unspontaneous existence.
But whenever they feel something negative or problematic, have them just pinpoint it. Paul got better at delineating his inner negative experience and naming it.
When we name something, we can gain a sense of power over it in some strange way. This may well be because when we name a feeling, we do so using the prefrontal lobes of the brain – the area responsible for ‘executive function’ – which calms down the emotional, limbic centres of the brain and therefore restores a sense of control over ourselves and our situation.
Perhaps that was part of the drive for the initial development of human language!
Of course, it isn’t always appropriate to do a deep dive into our feelings! During an emergency, say, it may be adaptive to suppress feelings so we can just do what is required. But day-to-day feeling suppression tends to make us feel worse, not better. And actually, people who try not to focus on or face their feelings or thoughts tend, ironically, to return to them much more.5,6
When we face what is inside, recognize and name it, we become stronger and less afraid.
By helping our clients recognize and name their emotions, we can help them lead more fulfilling and authentic lives.
And as for my bias against the “how does that make you feel?” question, maybe my real feeling was a sense that it could be used better – something I hope you now feel more equipped to do.
An Uncommon Approach to Treating Depression
For a whole new way to understand and treat depression, take a look at Mark’s Depression Course. Mark has been teaching this approach for more than 20 years and thousands of practitioners have experienced the game-changing effect it has on their treatment of depressed clients. Read more here.
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