Therapist Corner

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​"In the eye of the storm, You remain in control In the middle of the war, You guard my soul You alone are the anchor, when my sails are torn Your love surrounds me, in the eye of the storm"
​-Ryan Stevenson

Emotions: A Frequent Visitor of Anxiety by Erika Pineros MA​

When clients come into therapy they often describe somatic symptoms of anxiety, but once we get into the core of treating anxiety, things can get messy. A can of worms opens when emotions and cognitions are explored together. This is never an easy task since emotions often lead to the feeling of vulnerability.  Let’s face it, nobody enjoys feeling vulnerable. As I work with clients, I will let them know that it will be first uncomfortable but critical to explore and identify emotions. This is the first step towards being able to later express them and learn how to effectively cope or change set emotions.

The physical discomfort of exploring emotions is the brain’s response to protecting the body from harm. Emotions are controlled by the limbic system in the brain, particularly, the amygdala. When the amygdala is stimulated it can cause fear, anxiety, and anger among other basic primal emotion without differentiating real versus perceived threat.  

Clients who have anxiety often experience the feeling of uncertainty and fear as a result of the brain's’ response to perceived threat. Clients may feel uncertain about their job, relationships and the future among others. This uncertainty also creates fear of the unknown, which leads a client to feel that they are losing control. The goal of therapy is to identify emotions and learn effective ways of regulating these emotions.

Often times when I ask clients what it is that they are feeling, they often find it very difficult to answer that question. It is never one emotion, it is usually a combination of all kinds of feelings, and clients have a hard time identifying those emotions because there are so many. Using the principles of Dialectal Behavioral Therapy (DBT), the first step is to identify the emotions. When I see that the client is struggling in identification, a list of emotions can be very helpful; clients frequently can’t name the emotion, so providing a list of emotions is useful. It is important to understand that no feeling is either right or wrong, which is different from the perception or belief that is causing the emotion. For example, a female client is angry with their mother. The feeling is not right or wrong, however, perhaps her perception, “I’m so angry at her, I asked her for one favor which was to put the letter in the mail but she is always trying to do things to hurt me”. In this case the perception is that the mother’s behavior was intentional and this may or may not be right. I have seen many clients that believe that what they are feeling is wrong, which is why they do not want to talk about or admit having that feeling.

After the identification phase, I work with clients in learning how to express their emotions. Most clients have coped with these emotions by suppressing them/ avoiding them. Others are so overwhelmed by these emotions that they often believe that they “lash out”, and consider themselves to be very impulsive in the way they handle emotions such as anger and frustration.  As mentioned in the last issue, anxiety usually has it’s roots in a past trauma. When the body is triggered it sets signals to the brain that the client is in immediate danger, which results in the fight, flight or freeze response. This is an automatic response, which means that there is no conscious thought about how to react. This is similar to how emotions are handled, it becomes automatic. For example, if there is an argument between two people in a relationship, one may express their anger by screaming and the other by walking out and not saying a word. In that interaction, neither of them is consciously thinking about how they are expressing their emotions. The way individuals express emotions is a learned behavior that becomes automatic. If not showing emotions was reinforced in a household; this behavior is continued throughout other relationships. Once the client has learned how to effectively express emotions, they then learn how to effectively communicate emotions. For example, if a client felt angry with their spouse, I would have the client communicate the emotion to the spouse.

If you are a client who suffers from anxiety and can identify with needing help in regulation emotions, please visit the client tools of the month page. There you will find tools that will help coping with these emotions in a healthier way. ​