Psychoanalyst Rollo May suggests that “the mature person becomes able to differentiate feelings into as many nuances, strong and passionate experiences, or delicate and sensitive ones as in the different passages of music in a symphony.” For many of us, however, our feelings are, as May would describe it, “limited like notes in a bugle call.” ~NVC, Rosenberg

Many people in Western society don’t know how to deal with their emotions in an appropriate manner, and I often work on emotional health with clients. While 5 to 10% of the population has alexithymia (an inability to identify and describe emotions), for most people, their emotional illiteracy is rooted in their upbringing (i.e., emotionally illiterate parents) and a culture that stigmatizes most emotional expression. I wrote two articles on my approach to emotional health in therapy:

• Part 1 Covers a way of conceptualizing emotional experience and emotional regulation 

• Part 2, this article you’re reading now, addresses how to process and let go of old emotional baggage

Emotions are a natural part of the human experience, and they can provide information about our needs, worldview, beliefs, assumptions, and so on. Significant emotional avoidance can lead to acting out in uncharacteristic ways, create or enhance cognitive distortions, depression, addictions, and other maladies. “Emotion” derives from the Latin word “emovere” meaning to move; emotions represent energy that needs to go somewhere. Therapists need to be able to apply these skills to themselves and to educate clients on the subject when relevant.

Below I go over:

What does processing emotions mean?

Why Process Emotions in Therapy?

How do you determine if there’s emotion that needs processing?

How to process emotions in therapy

The continuum of processing Emotions

Methods of Processing Emotion

Grounding and Emotional Containment

What processing emotion means:

TLDR:  

• Emotional processing: working through, accepting, or “letting go” of older, more significant emotion (e.g., shame and grief from a series of events 6 years ago). 

• Emotional regulation: dealing with our moment to moment or short term feelings (e.g., worried and frustrated that a friend hasn’t called me back yet this evening)
  
  

Processing emotions means that instead of continuing to avoid old internal wounds, we turn toward them with self-compassion and ‘allow’ the emotional energy to run its course through us. This experience is intuitive for some people. Otherwise, a deliberate approach starts with identifying and investigating what we’re feeling to bring some of it to the front of our awareness, then ‘allowing’ the painful experience to occur. Embrace the emotion for a time, like the opposite of avoidance or distracting yourself from the feelings. 

Being in touch with our emotions does not mean we’re sad all the time. Instead, a healthy relationship with emotions means processing emotions when we notice them (or within an appropriate timeframe) and then not having to carry them around anymore. While this requires courage and discomfort, the long term outcome is increased inner peace. It’s easier to heal (i.e., come to terms with things as they are) after doing this work.

An exaggerated example of emotional processing is: imagine someone you love dies. You attend the funeral and feel numb, and you think you should feel upset but you don’t, so instead you feel more numb or guilty. The next day, you’re washing dishes and pick up a mug that person gave you for your birthday years ago, and suddenly you feel waves of grief in your body and you’re crying. Letting this grief out is processing. Seeking or encouraging the experience is wise, when done in appropriate moments. The release needs to happen at some point, so do it at a reasonable and safe time, rather than wait for it all to burst out during a time of stress, or build up and make us feel drowned by depression, or turn to substance use for an escape, and so on. Further, when we consciously choose to process, we can do so one piece at a time, rather than in one awful marathon.

Why Process Emotions in Therapy?

TLDR: Old or ‘stuck’ emotions can be a barrier to healing and moving forward for clients. Once therapists help clients release that pressure, clients often feel freer to actively pursue change.

Emotions have a childlike quality: when we ignore emotions or attempt to stop them, they’ll cry harder. Emotions are a wonderful and essential part of the human experience, just like water is for the body—but unfamiliar waters can drown a distracted swimmer. Fortunately, clients can collaborate with us to learn about emotional health, and we can join them during their first few times in deep water.

During sessions with me, clients frequently cry; I even gently guide clients toward this experience and will nudge them over the edge of emotionality when appropriate. I do this because I think emotional baggage is a barrier to growth, and many people have been avoiding their feelings, often for years. So after building an alliance and setting the stage, clients often feel safe enough with me to explore painful subjects. Clients may have never expressed their emotional wounds openly, at least not as adults. It’s powerful to release these feelings, and more so when it’s witnessed and validated by a caring person. 

The behavioural solutions to client concerns are often quite simple—it’s usually the emotions, and later the change in personal meaning, that are more complex or cause hesitation toward change. When a person finally allows themselves to experience their emotions, I encourage them to sit with the moment in session. Provide respectful silence while clients process, as well as validation and normalization if relevant. The clarity and shift in clients’ thinking following these moments can be striking; they’ll say things such as:

• “I can’t believe I let him treat me like this for so long, I’m going to…”

• “Life’s too short to feel trapped and overwhelmed like this. I need to change, how can I do that?”

• “I’m done carrying this around. I’m going to do the work of letting it go, and then I’m going to move forward, finally.”
  
  

I find clients are more willing to focus on acceptance and making changes after we’ve made room for their emotional experience in session. It’s as if the client’s emotions were freezing them in place, and the actions they ‘should’ have been taking had been building up for months or years. Once we ‘thaw’ those emotions out, many clients begin taking action again. As gratifying as it would be, it’s somewhat rare that these moments of emotional release in session lead to radical or sudden change. More often, this acts as a pivotal moment, a shift in the client’s stage of change whereafter action is more attainable. It’s as if a softening finally occurred.

How to determine if there’s emotion that needs processing

TLDR: If you are reminded of a difficult situation, can you feel the emotions connected to that situation and ‘handle’ the experience? Or is it painful and overwhelming, requiring immediate avoidance? Can you “feel and deal”?

Measuring whether a person has emotions they need to process is more art than science. To get a rough estimate, use the “feel and deal” idea: when a painful memory comes to mind, can the client sit with that emotion? If not, that’s okay and normal, and it indicates a person likely has additional exploring and healing to do in that context.

I hesitate to put specific numbers on how long is too long to be upset by an event, though the DSM defines time frames related to adjustment disorders, stress disorder, and PTSD. Another indicator I saw was that if a person continues to have a painful emotional reaction to a memory 18 months after the event, they likely have not fully articulated and processed the experience. I’m unconvinced and wouldn’t apply it to many situations, such as the death of a child or similar tragedy. 18 months may be a reasonable guideline for more “normal” circumstances though.

A well known experiential practice I use while doing psychoeducation related to emotions is to have the client hold some object (e.g., their water bottle) in their hand, at shoulder height with their arm fully extended away from them. After a minute, I ask what it was like to hold the object up like that. For most people it was easy at first but became an increasing strain as time passed; carrying stress and old emotions around is similar. This small demonstration often generates good discussion and is engaging.

How to process emotions:

1. Acknowledge when you notice that you’re not feeling ok

2. Identify your emotions accurately, ideally using a feelings wheel

3. Ask yourself “why am I feeling these emotions in this situation?” and reflect on this, or ask “what are my emotions trying to tell me?”

4. Sit with and witness your emotional experience, honouring it until it passes (you’ve got to “feel it to heal it”). Recognize when you’ve done enough then stop for the day. This work can be tiring or overwhelming depending on individual circumstances (e.g., trauma), so approach processing with care

5. Create a coherent narrative about what happened, looking toward accepting the reality of the situation, perhaps recognizing lessons learned from the situation 

6. Adapt it to fit within how you make sense of your lived experience and sense of identity, or adapt that sense if needed

7. Vulnerability: share the experience and the new meaning (further solidify it via validation)
   
   

That’s the basic process. Step 4 can seem abstract and is the one most people get lost in, and this is where I focus for the remainder of this article. 

A note about step 7: sharing the experience with others is not mandatory. However, in my experience, when we have safe and supportive people to talk the experience through with, it helps a person heal more thoroughly and more promptly. In these sensitive moments, receiving empathy and validation is helpful. 

The continuum of emotional processing:

I like to discuss the “I don’t speak Spanish story”, the vase metaphor script from part 1, the anger iceberg, and so on with a client so they have a concrete way of conceptualizing emotional experience. That understanding is crucial to progress as we continue discussing how this metaphor connects with their own story.

At times these are long conversations wherein the client and I are processing some of their feelings right in the moment. A common experience is for clients to tell me how overwhelmed they feel by all these emotions they’ve been carrying around, or if I suggest it must have been exhausting to carry all this around, the client may begin crying, if they hadn’t already. This happens for a variety of reasons, but generally it’s because people rarely feel witnessed, cared for and attended to closely, having a person demonstrating understanding and so on. These can be poignant and affecting moments in session for both the client and therapist.

What I’m waiting for is for the client to specifically ‘invite me’ to help them again. If I have timed things well as it relates to the client’s current stage of change and shared it concisely after they’ve felt heard and understood, AKA some time after they’ve invited me to help them the initial time, the client will say things such as (depending on the metaphor we’d been using):

• “Ok, so how do I get some of that water out of the bottom of the vase, that’s sort of stuck down there?”, or

• “How do I get that molding food out of the back of the fridge though?”

• “I wish I could let some of this shit go; I just don’t know how, trying has never worked”, as they gesture to all the things we wrote under the water on their anger iceberg
  
  

Following this invitation, I’ll acknowledge that “you’re right, so far we’ve been talking through what’s happened, how you got here, how these kinds of feelings can pile up. That’s interesting, but what is useful is knowing what to do about it—knowing how to let this kind of thing go so we can feel a bit better. There are many ways we can do this.” Here I use solution-focused questions to probe about what has worked for them in the past. Then I discuss what I call the continuum of emotional processing. 

I explain that “there are a lot of options for processing old emotions. They all work for someone; we just need to find the ones that work for you. Here are some examples, which I’ll put roughly in order of ‘efficiency’, meaning, how quickly the emotions might be released by working through the activity. The order of which technique is most effective varies for each of us, and even varies by what emotions, our mood that day, our needs, and so on.” Then I’ll sketch the following line diagram or simply gesture in the air, describing it while we discuss it:

Techniques to Process Emotions

The following methods are based in the premise that “you’ve got to feel it to heal it”. There are many options beyond what are described below, and feel free to be creative with them. These techniques are aimed at step 4 from the “how to process emotions” list above, and they further detail some of the approaches listed on the continuum image.

Asking Emotions what they Need

An exercise for accessing emotion in session that I enjoy is to ask a client to locate the emotion in their body. What does it feel like, does it have a color or sound, what size is it, does it move? I ask them to put their hand on that area, if they’re comfortable doing so. Then I say “let me ask you a strange question. If that feeling could talk to us, what would it say? What would it say that it needs?”

The answers clients give me are often rudimentary things such as needing to feel safe, to feel accepted, heard, and so on. This is often a moment where I let silence hang as clients sit with their articulation, which is an emotional need they may have not acknowledged in years. It is often a powerful moment and can lead to excellent discussion. This is impactful for clients with frequent somatic complaints or who have difficulty connecting with emotions. On a related note, a common question I ask clients (and encourage them to ask themselves) is “what do you need?”

Draw How you Feel

This is a simple exercise that any client can do. I ask clients to draw how they feel, either in session for 10 or 20 seconds with a pen, or sometimes clients want to do this at home and take their time. It’s great for clients who enjoy visual art, but anyone can do it. This exercise can be surprisingly evocative and lead to vulnerability and good process discussion. I’ve had clients suggest they write a poem or short story for a similar purpose, to great effect.

Emotions and Immediacy in Therapy

While many of the techniques here are options clients can do outside of session, there are many ways to encourage emotional processing in session. I tend to ask process questions in therapy, which is a complex and nuanced subject by itself. Another option is Yalom-style processing of the therapist-client relationship because it often becomes a microcosm of other relationships in the client’s life. This approach requires substantial self-awareness and vulnerability on the part of the therapist. Yalom demonstrates this in many of his books, for example The Gift of Therapy and Love’s Executioner.

Fritz Perls was an interesting therapist who was known for making observations about physical gestures and expressions clients were making. He’d repeat the movement himself, asking the client to repeat the movement as well, and asking them what it means and how it feels to it. There are videos online where you can observe him doing this. It’s a unique style and perhaps confrontational. It’s not something I do often, though when I have a good alliance with a client and there’s a relevant moment, I may riff on this kind of immediacy.

Using immediacy is context dependent and requires therapists create their own ways of exploring moments. Microskills such as reflection, validation, normalizing, and use of silence are important here. Other examples could be pointing out a change in the client’s affect when they discuss certain topics and asking them about that shift, asking about their body language, pointing out an apparent mismatch between their tone and the content of what they’re saying, or asking if the client notices how quickly they change the subject when a certain concern arises. Effective use of immediacy in therapy is one of those things that is simple but not easy; it can feel risky even for experienced therapists.

Exercise

Processing emotion can involve an activity; not everything needs such ‘deep cleaning’ as other more direct methods offer. Physical activity is the preferred method of emotional processing for some people. Clients who run marathons almost always know what I mean when we talk about the emotional utility of running, how cleansing and perspective shifting it can be to go for a long run. 

Any form of exercise could work for this. I enjoy it with weight lifting, rock climbing, rowing, and yoga, to give some examples. You’re basically doing a meditation, imagining the emotion coming out of you with each exertion. This will vary by activity and how you prefer to do it; sometimes it is a visual meditation where you imagine this happening, or it can be a sensation. Imagining the emotion radiating out of you like body heat is another example, but my clients come up with their own all the time. Being able to identify where in your body the emotion resides can help but isn’t required. Sometimes it helps to think more directly about the troubling situation during exercise, other times it’s a background process. There is lots of room to experiment.

Meditation for Emotional Release

There are many forms of meditation that can aid in emotional connection and release. Visual meditations of release, expansiveness, or healing light are good examples, as are meditating on a koan, a phrase or chant, loving-kindness meditations, and so on. Jon Kabat-Zinn often says that awareness itself is profoundly healing, that the “silence and stillness” of meditation is inherently beneficial.

Kristin Neff describes a beautiful exercise in her book Self-Compassion. She believes that suffering = pain x resistance, and she suggests that the following exercise can aid in reducing emotional resistance, helping us to welcome the emotions so they pass through us. 

In a relaxed position and quiet location, similar to a meditation, start by saying things like “I love you and I’m listening” to yourself or put your hand on your heart to indicate to your attention and care to your body. Attend to simple sensations you feel in your body, such as “I notice my arms have a tingling feeling”, “my chest feels heavy and tight”, or “my throat feels tight, like I can’t speak”. Sit with and continue to be curious about these sensations, offering soothing words of compassion to yourself and the sensations, similar to how you would comfort a child. 

This caring attentiveness is enough to initiate a flood of emotion for many people, which we then sit with and comfort. It can feel scary to contemplate, a common concern being “if I let myself start feeling this sadness I worry I’ll never stop”. In reality, typically this is a short exercise, lasting 10 minutes or less for ‘smaller’ concerns or if you let your emotions out regularly. For more ‘intense’ emotion it’s good to approach the process piece by piece and take breaks, which I discuss below in a section on containment. Neff goes into more detail in her book if you want more information.

RAIN meditations 

Tara Brach is a wonderful psychologist and author who focuses on mindfulness and compassion. She is well known for her updated RAIN meditation, which can be summarized as:

Recognize what is happening (roots of understanding)

Allow life to be just as it is (grounds of love)

Investigate with gentle attention (deepens understanding)

Nurture (awakens love)

After the RAIN (realizing freedom from narrow identity)

Tara does an excellent job of explaining the subject on her site and in her guided meditations.

Look at a Feelings Wheel

Simply review a feelings wheel and find the emotions that you relate to in that moment. For me this is the most direct route to steps 2, 3, and 4 described above in the ‘how to’ section. This technique can be useful for clients who struggle to connect with their emotions because the feelings wheel prompts them so clearly.

Journalling in Therapy

Journalling can be a healthy outlet for emotions. By journalling in therapy, I mean writing in a private space in an honest manner about how you’re feeling, what’s going on in the troubling situation, and your internal experience of it. The less you censor yourself, the better. I’m not suggesting clients record a tedious history of how they spent their day.

Some clients enjoy journaling daily, though after years I’ve realized that what works best for me is to be prompted 3 or 4 times a week to consider if I need to journal. When I concur with the prompt that something’s off and I need to reflect, I journal as needed, otherwise I disregard the prompt. I use one of the many habit tracking apps to organize this kind of self-care (e.g., ToDoist, Habitica, Trello, etc). 

Research has found that both written and spoken journalling are effective. Some clients don’t enjoy writing, so I suggest they hit record on their phone and talk the issue through. I don’t keep my journal entries, so I type it and delete it. Some clients may find utility in reviewing older entries, but I do not. When I gain an insight through journalling, I keep that brief idea in a separate document. Each of us builds a unique practice with this kind of work, so I encourage clients to experiment and keep what works for them.

Journalling prompts are a useful option to get clients started, which they can find by searching online. I find prompts helpful for journalling about grief, for example. Lastly, there are self-compassion journalling exercises available; Kristin Neff does good work in this area.

Emotions as Information about our Needs

Practical-minded clients may prefer a more concrete approach to “doing something about” their emotions. I explain that emotions indicate our needs, and that we can’t meet our needs unless we know what they are. A metaphor I picked up from a colleague is: imagine trying to fix a car that refuses to start, but the only diagnostic information you have is “the car won’t start”. Is it out of gas? Is the battery dead? Do I have the wrong set of keys? We don’t know. 

Our body tries to provide us with information about our needs. Consider foundational sensations such as hunger or feeling cold. Our body provides this sensory information about a need, and we generally use that information to improve how we feel. Similarly, emotions can indicate our needs to us: 

• Anger can show that a boundary of ours has been crossed, what we’re passionate about, that we may not have been communicating our needs and preferences assertively, and so on

• Shame may indicate that we internalized others’ opinions of who we ‘should’ be or who we are, that instead reconnection with ourselves would be helpful

• Sadness can indicate our need for support and the depth of our empathy

Consider asking yourself “what is this emotion here to teach me?” 

Emotional Containment and Grounding

Therapists must remain sensitive to their client’s level of skill, tolerance, and stability when facilitating the client’s emotional processing or encouraging the client to do more processing outside of session. Clients can become overwhelmed by this work, especially if the emotions they’re processing are coming from traumatic situations. So, ensure clients know how they’ll decide when it’s time to take a break from the processing and how to self-soothe. I covered relevant emotional regulation skills in part 1. 

An interesting approach to emotional containment is to have the client imagine a storage vessel to keep their difficult or painful emotions inside of. The client can imagine placing their feelings inside the container, which can allow distance between themselves and their feelings. Examples could be a tea cup, a wooden box, or a bomb shelter—anything the client wants. Then, rather than being flooded by the emotions, the client can hopefully regain some control by storing the difficult emotions in the container, only taking them out when they are working with them. 

You could create a schedule to remove 2 percent of the emotions each day or each weekend, and the client only needs to concern themselves with processing that smaller amount and then they stop. I know some therapists will invite clients to “leave” a particularly troubling feeling or memory with the therapist, in their office somewhere. Again, there is a lot of room for creativity with this kind of thing, and while imagery like this is not a good fit for every client, it’s another useful tool.

Consider the impact a person’s self-care has on their ability to do ‘deeper’ emotional work. If we’re not taking good care of our basic needs, then the thought of adding the burden of emotional work can seem daunting. A term I use for this is “managing our biology”. The more stable the other areas of a person’s life are, the more willing most people are to temporarily destabilize their emotions to do this kind of work.

Conclusion

We have to slow down and listen carefully if we’re going to have a healthy relationship with our emotions. Some people are highly emotional and perhaps don’t need additional techniques but instead can benefit from the containment and grounding. However, for many people (men especially), learning to notice, listen to, and experience emotions is difficult. Acknowledging our inner experience is healthy and normal.

As a warning, while the above approaches can be of use in trauma work, be aware that trauma is an entirely different area of therapy that requires specialized knowledge, training, and supervision when new to the work. Do not jump into trauma therapy only armed with the knowledge I shared here.

Working effectively with clients’ emotions in session demands that therapists are also doing the regular work of their own emotional processing and taking care of themselves. Emotional labor is difficult and under-appreciated, and it requires therapists to carefully monitor their needs so they have energy left for their lives outside of clinical work. I’ll leave you with a thought from Brene Brown: “vulnerability sounds like truth and feels like courage.”

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