Tag Archives: emotions

Clinical Interviewing, Personal Reflections

Working with Emotions in Counseling and Psychotherapy: Part 3

Leave a comment

Most people intuitively know that emotions are a central, complex, and multidimensional part of human experience. Emotions are typically in response to perceptions, include sensations, and are at the root of much of our existential meaning-making. Emotions are at the heart (not literally, of course) of much of the motivation that underlies behavior.

What follows is another excerpt from Clinical Interviewing (7th edition). In this excerpt, we define and explore the use of an interpretive reflection of feeling as a tool to go deeper into emotion and meaning with clients. As with all things interpretive, I recommend proceeding with caution, respect, and humility. . . because sometimes clients aren’t interested in going deeper and will push back in one way or another.

**********************************

Interpretive Reflection of Feeling (aka Advanced Empathy)

Interpretive reflections of feeling are emotion-focused statements that go beyond obvious emotional expressions. Sometimes referred to as advanced empathy (Egan, 2014), interpretive reflection of feeling is based on Rogers’s (1961) idea that sometimes person-centered therapists work on emotions that are barely within or just outside the client’s awareness.

By design, interpretive reflections of feeling go deeper than surface feelings or emotions, uncovering underlying emotions and potentially producing insight (i.e., the client becomes aware of something that was previously unconscious or partially conscious). Nondirective reflections of feeling focus on obvious, clear, and surface emotions; in contrast, interpretive reflections target partially hidden, deeper emotions.

Consider again the 15-year-old boy who was so angry with his teacher.

Client: That teacher pissed me off big time when she accused me of stealing her phone. I wanted to punch her.

Counselor: You were pretty pissed off. (reflection of feeling)

Client: Damn right.

Counselor: I also sense that you have other feelings about what your teacher did. Maybe you were hurt because she didn’t trust you. (interpretive reflection of feeling)

The counselor’s second statement probes deeper feelings that the client didn’t directly articulate.

An interpretive reflection of feeling may activate client defensiveness. Interpretations require good timing (Fenichel, 1945; Freud, 1949). That’s why, in the preceding example, the counselor initially used a nondirective reflection of feeling and then, after that reflection was affirmed, used a more interpretive response. W. R. Miller and Rollnick (2002) made this point in Motivational Interviewing:

Skillful reflection moves past what the person has already said, though not jumping too far ahead. The skill is not unlike the timing of interpretations in psychodynamic psychotherapy. If the person balks, you know you’ve jumped too far, too fast. (p. 72)

Interpretive reflections of feeling assume clients will benefit from going “vertical” or deeper into understanding underlying emotions; they can have many effects, the most prominent include the following:

  • If offered prematurely or without a good rationale, they may feel foreign or uncomfortable; this discomfort can lead to client resistance, reluctance, denial, or a relationship rupture (Parrow, 2023).
  • When well stated and when a positive therapy relationship exists, interpretive reflections of feeling may feel supportive because therapists are “hearing” clients at deeper emotional levels; this can lead to enhanced therapist credibility, strengthening of the therapeutic relationship, and collaborative pursuit of insight.

Interpretive reflections of feeling are naturally invasive. That’s why timing and a good working alliance are essential. When using interpretive reflections of feeling, follow these principles.

  • Wait until:
    • You have good rapport or a positive working alliance.
    • Your clients have experienced you accurately hearing and reflecting their surface emotions.
    • You have evidence (e.g., nonverbal signals, previous client statements) that provide a reasonable foundation for your interpretation.
    • Phrase your interpretive statement:
    • Tentatively (e.g., “If I were to guess, I’d say…”)
    • Collaboratively (e.g., “Correct me if I’m wrong, but…”)

The need to phrase statements tentatively and collaboratively is equally true when using any form of feedback or interpretation. Many different phrasings can be used to make such statements more acceptable.

  • I think I’m hearing that you’d like to speak directly to your father about your sexuality, but you’re afraid of his response.
  • Correct me if I’m wrong, but it sounds like your anxiety in this relationship is based on a deeper belief that she’ll eventually discover you’re unlovable.
  • If I were to guess, I’d say you’re wishing you could find your way out of this relationship. Does that fit?
  • This may not be accurate, but the way you’re sitting seems to communicate not only sadness but also some irritation.

*************************************

I hope this content has been of some interest or use to you in your work. If you want a bit more, a couple of emotion-related case examples are at the link below (and you can always buy the book:)).

two-emotion-related-case-examplesDownload
Cool Counseling, Happiness, Personal Reflections, Therapy with Adolescents, Writing

Let’s Do the “Three-Step” (Emotional Change Trick)

Leave a comment

This morning’s weekly missive of “most read” articles from the Journal of the American Medical Association included a study evaluating the effects of high-dose “fluvoxamine and time to sustained recover in outpatients with COVID-19.” My reaction to the title was puzzlement. What could be the rationale for using a serotonin specific reuptake inhibitor for treating COVID-19? I read a bit and discovered there’s an idea and observations that perhaps fluvoxamine can reduce the inflammation response and prevention development of more severe COVID-19.

To summarize, the results were no results. Despite the fact that back in the 1990s some psychiatrists and pharmaceutical companies were campaigning for putting serotonin in the water systems, in fact, serotonin doesn’t really do much. As you know from last week, serotonin-based medications are generally less effective for depression than exercise.

For the happiness challenge this week, we’re touting the effectiveness of my own version of what we should put in the water or in the schools or in families—the Three-Step Emotional Change Trick. Having been in a several month funk over a variety of issues, I find myself returning to the application of the Three-Step Emotional Change Trick in my daily life. Does it always work? Nope. Is it better than feeling like a victim to my unpleasant thoughts and feelings? Yep.

I hope you’ll try this out and follow the instructions to push the process outward by sharing and teaching the three steps. Let’s try to get it into the water system.

Active Learning Assignment 9 – The 3-Step Emotional Change Trick

Almost no one likes toxic positivity. . . which is why I want to emphasize from the start, this week’s activity is NOT toxic positivity.

Back in the 1990s I was in full-time private practice and mostly I got young client referrals. When they entered my office, nearly all the youth were in bad moods. They were unhappy, sad, anxious, angry, and usually unpleasantly irritable. Early on I realized I had to do something to help them change their moods.

An Adlerian psychologist, Harold Mosak, had researched the emotional pushbutton technique. I turned it into a simple, three-step emotional change technique to help young clients deal with their bad moods. I liked the technique so well that I did it in my office, with myself, with parents, during professional workshops, and with classrooms full of elementary, middle, and high school students. Mostly it worked. Sometimes it didn’t.

This week, your assignment is to apply the three-step emotional change trick to yourself and your life. Here’s how it goes.

Introduction

Bad moods are normal. I would ask young clients, “Have you ever been in a bad mood?” All the kids nodded, flipped me off, or said things like, “No duh.”

Then I’d ask, “Have you ever had somebody tell you to cheer up?” Everyone said, “Yes!” and told me how much they hated being told to cheer up. I would agree and commiserate with them on how ridiculous it was for anyone to ever think that saying “Cheer up” would do anything but piss the person off even more. I’d say, “I’ll never tell you to cheer up.* If you’re in a bad mood, I figure you’ve got a good reason to be in a bad mood, and so I’ll just respect your mood.” [*Note to Therapists: This might be the single-most important therapeutic statement in this whole process.]

Then I’d ask. “Have you ever been stuck in a bad mood and have it last longer than you wanted it to?”

Nearly always there was a head nod; I’d join in and admit to the same. “Damn those bad moods. Sometimes they last and last and hang around way longer than they need to. How about I teach you this thing I call the three-step emotional change trick. It’s a way to change your mood, but only when YOU want to change your mood. You get to be the captain of your own emotional ship.”

Emotions are universally challenging. I think that’s why I never had a client refuse to let me teach the three-steps. And that’s why I’m sharing it with you now.

Step one is to feel the feeling. Feelings come around for a reason. We need to notice them, feel them, and contemplate their meaning. The big questions here are: How can you honor and feel your feelings? What can you do to respect your own feelings and listen to the underlying message? I’ve heard many answers. Here are a few. But you can generate your own list.

  • Frowning or crying if you feel sad
  • Grimacing and making angry faces into a mirror if you feel angry
  • Drawing an angry picture
  • Punching or kicking a pillow (no real violence though)
  • Going outside and yelling (or screaming into a pillow)
  • Scribbling on a note pad
  • Writing a nasty note to someone (but not delivering it)
  • Using your words, and talking to someone about what you’re feeling

Step two is to think a new thought or do something different. This step is all about intentionally doing or thinking something that might change or improve you mood. The big question here is: What can you think or do that will put you in a better mood?

I discovered that kids and adults have amazing mood-changing strategies. Here’s a sampling:

  • Tell a funny story (“Yesterday in math, my friend Todd farted”)
  • Tell a joke (What do you call it when 100 rabbits standing in a row all take one step backwards? A receding hare-line).
  • Tell a better joke (Why did the ant crawl up the elephant’s leg for the second time? It got pissed off the first time.)
  • Exercise!
  • Smile into a mirror
  • Talk to someone you trust
  • Put a cat (or a chicken or a duck) on your head
  • Chew a big wad of gum

I’m sure you get the idea. You know best what might put you in a good mood. When you’re ready, but not before, use your own self-knowledge to move into a better mood.

Step three is to spread the good mood. Moods are contagious. I’d say things like this to my clients:

“Emotions are contagious. Do you know what contagious means? It means you can catch emotions from being around other people who are in bad moods or good moods. Like when you got here. I noticed your mom was in a bad mood too. It made me wonder, did you catch the bad mood from her or did she catch it from you? Anyway, now you seem to be in a better mood. I’m wondering. Do you think you can make your mom “catch” your good mood?”

How do you share good moods? Saying “Cheer up” is off-limits. Here’s a short list of what I’ve heard from kids and adults.

  • Do someone a favor
  • Smile
  • Hold the door for a stranger
  • Offer a real or virtual hug
  • Listen to someone
  • Tell someone, “I love you”

Step four might be the best and most important step in the three-step emotional change trick. With kids, when I move on to step four, they always interrupt:

“Wait. You said there were only three steps!”

“Yes. That’s true. But because emotions are complicated and surprising, the three-step emotional change trick has four steps. The fourth step is for you to teach someone else the three steps.”

Here’s a youtube link to me doing the 3SECT: https://www.youtube.com/watch?v=ITWhMYANC5c

If you want to chase down an early version/citation, here’s a link for that: https://www.tandfonline.com/doi/abs/10.1300/J019v17n04_02

Cool Counseling, Happiness, Tough Kids Cool Counseling

The Three-Step Emotional Change Trick, Revisited (Again) . . . with a side note on plagiarism

2 Comments

I’ve said it before and I’ll say it again: I have a friend who repeatedly espouses the glories of redundancy. Maybe that’s why some politicians stay on-message, regardless of the veracity of their statements. Of course, George Orwell and Hannah Arendt also commented on redundancy as persuasion, and not in a good way. I should emphasize that my goal for using redundancy and writing about the three-step emotional technique again has nothing to do with shaping your reality through political messaging.

When I presented on positive psychology to a bunch of UM STEM graduate students back in August, 2022, I made it very clear that I was not advocating toxic positivity. Nevertheless, in one of the student evaluations, someone complained that all I was doing was telling graduate students to “Cheer up.” Oh my. Sometimes people just hear what they want to hear. That’s a problem with over-valuing “lived experience.” When we over-value lived experience, then everything is viewed through our own, usually narrow and biased, personal lenses. Adler called this private logic. Too much private logic is too much private logic. Although we should strive to value, learn from, and share lived experiences, we should also have a shared value of this thing called . . . wait for it . . . science!

The next time I presented to the UM STEM grad students (in January, 2023), I made an explicit point of emphasizing my “non-toxic positivity street cred” by beginning the lecture with a short lesson on the three-step emotional change trick (which, BTW, with inspiration from Alfred Adler and Harold Mosak, we created as a youth psychotherapy technique in the mid-1990s). You can even find our (with Rita) original three-step article here: https://www.tandfonline.com/doi/abs/10.1300/J019v17n04_02 and a later book chapter here: https://psycnet.apa.org/record/2002-01308-098 and, of course, I’ve written about it on this blog, and have a youtube video demonstration: https://www.youtube.com/watch?v=ITWhMYANC5c, yada, yada, yada.

While presenting the 3SECT (which is what cool people call it) to the STEM students, there was a woman sitting toward the back. She had stationed her 8-year-old son still farther back, where he was sitting, head down, playing on her phone. I did the 3SECT thing, including the famous “And so I put my cat on my head” scene, emphasizing throughout, that the WHOLE reason for the 3SECT existing was because we should NEVER SAY CHEER UP to anyone, anytime!

The next day, I received the following email from the anonymous woman in the back (who generously gave me permission to share it here):

Hi John,

I was at your happiness seminar yesterday and was very disappointed I had to leave early. You may have noticed my son (who is 8) was sitting in the back playing a game on my phone during the seminar. I was delighted to find out this morning, while my 6-year-old daughter was having a meltdown trying to do her hair for school, that my son had been listening and absorbed your 3-step emotional change trick. He remembered the whole thing, and he asked his sister this morning if she wanted to learn it, but only if she wanted to change her own mood. He was clear that it wasn’t because he was trying to tell her to cheer up. He heard it all yesterday! Thought you might enjoy that little anecdote.

A few days later, she wrote:

We have gotten a lot of mileage out of your emotional change trick in the last few days.

I have to admit, I absolutely love it when people listen and get the message, but I truly and deeply love it EVEN MORE when 8-year-olds absorb messages while allegedly playing on a cell phone. I believe this may just be the scientific evidence (or is it my lived experience) I needed to validate that I am not and never have been a proponent of toxic positivity.

One other notable note. When searching (via Google) for my very own 3SECT video, I found that a counselor in Tennessee has copied one of my three-step blog posts and posted it as his own blog post. I was gobsmacked—with annoyance and flattery in equal proportions. If you want to read the blog post worthy of plagiarism (not the plagiarist’s version, which is the same, but my version that was so darn tempting that it literally caused plagiarism, here you go: https://johnsommersflanagan.com/2020/04/15/the-three-step-emotional-change-technique/

I’m ending now with a few core messages:

  • Don’t say “cheer up” to anyone.
  • Don’t get too over-focused on your own lived experiences, because, after all, everyone has their own lived experiences, and we should complement them all with scientific knowledge.
  • Don’t plagiarize.
  • If the person you plagiarized emails you, asking you to stop plagiarizing or provide a citation, don’t ignore that person.
  • And, whenever appropriate, follow in the anonymous 8-year-old’s footsteps and spread the good mood – without saying cheer-up!
Clinical Interviewing, Suicide Assessment and Intervention, Writing

Seven Dimensions and Suicide Assessment and Treatment

2 Comments

To help practitioners focus on wellness within the whole person, Rita and I have been writing about seven life dimensions as they pertain to suicide assessment and treatment. Although treatments for individuals who are suicidal should focus on suicide, it’s also true that there’s much more to whole person in the room than suicidality. The seven dimensions we’re using include the following:

  1. The emotional dimension
  2. The cognitive dimension
  3. The interpersonal dimension
  4. The physical dimension
  5. The cultural/spiritual dimension
  6. The behavioral dimension
  7. The contextual dimension

The visual excerpt from chapter 4 included with this post (above) focuses on the emotional dimension. In chapter 4 we discuss how to use empathy to emotionally connect with clients, but also on a variety of strategies for helping clients (and students) develop strengths, resiliency, and wellness within the emotional dimension.

The book is primarily available the the American Counseling Association. Here’s the ACA link: https://imis.counseling.org/store/detail.aspx?id=78174

Clinical Interviewing, Personal Reflections, Writing

Hacking Affect and Mood in 325 Words

4 Comments

Rita Wood Surfing

Affect is how you look to me.

Affect involves me (an outsider) judging your internal emotional state (as it looks from the outside). Whew.

Mood is how you feel to you.

Mood is inherently subjective and limited by your vocabulary, previous experiences, and inclination or disinclination toward feeling your feelings.

Independently, neither affect nor mood makes for a perfect assessment. But let’s be honest, there’s no such thing as a free lunch, and there’s no such thing as a perfect assessment. Even in elegant combination, affect and mood only provide us with limited information about a client’s emotional life.

Our information is limited and always falls short of truth because, not only is there always that pesky standard error of measurement, also, emotion is, by definition, phenomenologically subjective and elusive. Emotion, especially in the form of affect or mood, is a particularly fragile and quirky entrepreneur of physiology and cascading neurochemical caveats. Nothing and everything is or isn’t as it seems.

As an interviewer, even a simple emotional observation may be perceived as critical or inaccurate or offensive in ways we can only imagine. Saying, “You seem angry” might be experienced as critical or inaccurate and inspire the affect you’re watching and the mood your client is experiencing to hide, like Jonah, inside the belly of a whale.

Oddly, on another day with the same client, your emotional reflection—whether accurate or inaccurate—might facilitate emotional clarity; affect and mood may re-unite, and your client will experience insight and deepening emotional awareness.

As a clinician, despite your efforts to be a detached, objective observer, you might experience a parallel emotional process. Not only could your understanding of your client deepen, but ironically, because emotional lives resist isolation, you might experience your own emotional epiphany.

Rest assured, as with all emotional epiphanies—including our constitutionally guaranteed inevitable and unenviable pursuit of happiness—you’ll soon find yourself staring at your emotional epiphany through your rear view mirror.

*************************************

Just for fun, below I’ve included a link to a brief clip of me doing a mental status examination with a young man named Carl. A longer version of my interview with Carl is available with the 6th edition of Clinical Interviewing. https://www.youtube.com/watch?v=1lu50uciF5Y

 

 

 

Parenting

The Secret Self-Regulation Cure: A Practically Perfect Parenting Podcast

Leave a comment

Rocks and Trunk Up

Often, parents and professionals place too much emphasis on children’s surface behaviors, such as “being patient and polite” or “high academic, athletic, or music/art achievements.” This isn’t terrible, but it misses an important idea. In fact, being a patient, polite, high achiever requires several different foundational skills or abilities. One of these foundational requisites is: Self-regulation.

In the latest Practically Perfect Parenting Podcast, Dr. Sara Polanchek and I talk about how to help children develop self-regulation skills. Aside from being fun and hilarious (I’m mocking myself here), this podcast includes useful (but not necessarily “secret”) information.

You can listen on iTunes: https://itunes.apple.com/us/podcast/practically-perfect-parenting-podcast/id1170841304?mt=2

Or you can listen on Libsyn: http://practicallyperfectparenting.libsyn.com/the-secret-self-regulation-cure?tdest_id=431110

 

 

 

Cool Counseling, Counseling and Psychotherapy Theory and Practice, Tough Kids Cool Counseling

Revisiting the 3-Step Emotional Change Trick — Including a Video Example

2 Comments

One of my current students asked where she might find a video example of the 3-Step Emotional Change Trick. Since I made up the Emotional Change Trick in 1997, the answer was easy: No such video exists.

Then I remembered that this past summer, while putting together video content with Wiley for our Clinical Interviewing text, I did a video demo of the 3-Step ETC with a 12-year-old girl. Due to space considerations, the footage didn’t make it into the text, but Wiley sent me a copy of the 6:44 minute clip.

Keep in mind that the girl in this video is exceptional. She’s the daughter of some friends and she agreed to be filmed for educational purposes. My sense is that she could have taught me the 3-Step ECT, but I tried to make it look like I was teaching her anyway.

Here’s the youtube link: https://www.youtube.com/watch?v=ITWhMYANC5c

And below you can read a version of the Emotional Change Technique adapted from Tough Kids, Cool Counseling:

*************************

The Three-Step, Push-Button Emotional Change Technique

            An early and prominent Adlerian therapist, Harold Mosak, originally developed and tested the push-button technique as a method for demonstrating to clients that thinking different thoughts can effectively change mood states (Mosak, 1985). The purpose of Mosak’s technique was to help clients experience an increased sense of control over their emotions, thereby facilitating a sense of encouragement or empowerment (Mosak, 2000, personal communication).

            Mosak’s push-button technique can be easily adapted to work with young clients. When we implement this technique with younger clients, we are playful and call it an emotional change trick. When using this technique with teenagers, we describe it as a strategy for gaining more personal control over less desirable emotions. In essence, the three-step, push-button, emotional change technique is an emotional education technique; the primary goal is to teach clients that, rather than being at the mercy of their feelings, they may learn some strategies and techniques that provide them with increased personal control over their feelings.

The following example illustrates Adlerian emotional education principles and Mosak’s push-button technique expanded to three distinct steps.

Case example.  Sam, a 13-year-old European American boy, was referred because of his tendency to become suddenly stubborn, rigid, and disagreeable when interacting with authority figures. Sam arrived for his appointment accompanied by his mother. It quickly became obvious that Sam and his mother were in conflict. Sam was sullen, antagonistic, and difficult to talk with for several minutes at the outset of the session. Consequently, the Three-Step, Push-Button Emotional Change Technique (TSPB) was initiated:

Preparation/Explanation.

JSF:     I see you’re in a bad mood today. I have this . . . well, it’s kind of a magic trick and I             thought maybe you’d be interested. Want to hear about it?

S:         (Shrugs).

JSF:     It’s a trick that helps people get themselves out of a bad mood if they want to. First, I need to tell you what I know about bad moods. Bad moods are weird because even             though they don’t really feel good, lots of times people don’t want to get out of their bad mood and into a better mood. Do you know what I mean? It’s like you kind of want to stay in a bad mood; you don’t want anybody forcing you to change out of a bad mood.

S:         (Nods in agreement.)

JSF:     And you know what, I’ve noticed when I’m in a bad mood, I really hate it when someone comes up to me and says: “Cheer up!” or “Smile!”

S:         Yeah, I hate that too.

JSF:     And so you can be sure I’m not going to say that to you. In fact, sometimes the best thing to do is just really be in that bad mood—be those bad feelings. Sometimes it feels great to get right into the middle of those feelings and be them.

S:       Uh, I’m not sure what you’re talking about.

JSF:     Well, to get in control of your own feelings, it’s important to admit they’re there, to get to   know them better. So, the first step of this emotional change trick is to express your bad feelings. See, by getting them out and expressing them, you’re in control. If you don’t  express your feelings, especially icky ones, you could get stuck in a bad mood even    longer than you want.

As you can see, preparation for the TSPB technique involves emotional validation of how it feels to be in a bad mood, information about bad moods and how people can resist changing their moods or even get stuck in them, hopeful information about how people can learn to change their moods, and more emotional validation about how it feels when people prematurely try to cheer someone up.

Step 1: Feel the feeling. Before moving clients away from their negative feelings, it’s appropriate—out of respect for the presence and meaning of emotions—to help them feel their feelings. This can be challenging because most young people have only very simplistic ideas about how to express negative feelings. Consequently, Step 1 of the TSPB technique involves helping youth identify various emotional expression techniques and then helping them to try these out. We recommend brainstorming with young clients about specific methods for expressing feelings. The client and counselor should work together (perhaps with a chalk/grease board or large drawing pad), generating a list of expressive strategies that might include:

  • scribbling on a note pad with a black marker
  • drawing an angry, ugly picture
  • punching or kicking a large pillow
  • jumping up and down really hard
  • writing a nasty note to someone (but not delivering it)
  • grimacing and making various angry faces into a mirror
  • using words, perhaps even yelling if appropriate, to express specific feelings.

The expressive procedures listed above are easier for young clients to learn and understand when counselors actively model affective expression or assist clients in their affective expression. It’s especially important to model emotional expression when clients are inhibited or unsure about how to express themselves. Again, we recommend engaging in affective expression jointly with clients. We’ve had particular success making facial grimaces into a mirror. (Young clients often become entertained when engaging in this task with their counselor.) The optimal time for shifting to Step 2 in the TSPB technique is when clients have just begun to show a slight change in affect. (Often this occurs as a result of the counselor joining the client in expressing anger or sadness or general nastiness.)

Note: If a young client is unresponsive to Step 1 of the TSPB technique, don’t move to Step 2. Instead, an alternative mood-changing strategy should be considered (e.g., perhaps food and mood or the personal note). Be careful to simply reflect what you see. “Seems like you aren’t feeling like expressing those yucky feelings right now. Hey, that’s okay. I can show you this trick some other day. Want some gum?”

Step 2: Think a new thought (or engage in a new behavior). This step focuses on Mosak’s push-button approach (Mosak, 1985). It’s designed to demonstrate to the client that emotions are linked to thoughts. Step 2 is illustrated in the following dialogue (an extension of the previous case example with John and Sam):

JSF:     Did you know you can change your mood just by thinking different thoughts? When you think certain things it’s like pushing a button in your brain and the     things you think start making you feel certain ways. Let’s try it. Tell me the funniest thing that happened to you this week.

S:         Yesterday in math, my friend Todd farted (client smiles and laughs).

JSF:     (Smiles and laughs back) Really! I bet people really laughed. In fact, I can see it makes you laugh just thinking about it. Way back when I was in school I had a friend who did that all the time.

The content of what young people consider funny may not seem particularly funny to adults. Nonetheless, it’s crucial to be interested and entertained—welcoming the challenge to empathically see the situation from the 13-year-old perspective. It’s also important to stay with and build on the mood shift, asking for additional humorous thoughts, favorite jokes, or recent events. With clients who respond well, counselors can pursue further experimentation with various affective states (e.g., “Tell me about a sad [or scary, or surprising] experience”).

In some cases, young clients may be unable to generate a funny story or a funny memory. This may be an indicator of depression, as depressed clients often report greater difficulty recalling positive or happy events (Weerasekera, Linder, Greenberg, & Watson, 2001). Consequently, it may be necessary for the counselor to generate a funny statement.

S:         I can’t think of anything funny.

JSF:     Really? Well, keep trying . . . I’ll try too (therapist and client sit together in silence for about 20 seconds, trying to come up with a positive thought or memory).

JSF:     Got anything yet?

S:         Nope.

JSF:     Okay, I think I’ve got one. Actually, this is a joke.  What do you call it when 100 rabbits standing in a row all take one step backwards?

S:         Huh?

JSF:     (repeats the question)

S:         I don’t know.  I hate rabbits.

JSF:     Yeah.  Well, you call it a receding hare line.  Get it?

S:         Like rabbits are called hares?

JSF:     Yup.  It’s mostly funny to old guys like me.  (JSF holds up his own “hare line”)

S:         That’s totally stupid, man (smiling despite himself). I’m gonna get a buzz cut pretty             soon.

When you tell a joke or a funny story, it can help clients reciprocate with their own stories.  You can also use teasing riddles, puns, and word games if you’re comfortable with them.

We have two additional comments for counselors who might choose to use a teasing riddle which the client may get wrong. First, you should use teasing riddles only when a strong therapeutic relationship is established; otherwise, your client may interpret teasing negatively. Second, because preteen and teen clients often love to tease, you must be prepared to be teased back (i.e., young clients may generate a teasing riddle in response to a your teasing riddle).

Finally, counselors need to be sensitive to young clients who are unable to generate a positive thought or story, even after having heard an example or two. If a young client is unable to generate a funny thought, it’s important for you to remain positive and encouraging. For example:

JSF:     You know what. There are some days when I can’t think of any funny stories either. I’m sure you’ll be able to tell me something funny next time. Today I was able to think of some funny stuff . . . next time we can both give it a try again if you want.

Occasionally, young clients won’t be able to generate alternative thoughts or they won’t understand how the pushbutton technique works. In such cases, the counselor can focus more explicitly on changing mood through changing behaviors. This involves getting out a sheet of paper and mutually generating a list of actions that the client can take—when he or she feels like it—to improve mood.

Sometimes depressed young clients will need to borrow from your positive thoughts, affect, and ideas because they aren’t able to generate their own positive thoughts and feelings. If so, the TSPB technique should be discontinued for that particular session. The process of TSPB requires completion of each step before continuing on to the next step.

Step 3: Spread the good mood. Step 3 of this procedure involves teaching about the contagion quality of mood states. Teaching clients about contagious moods accomplishes two goals. First, it provides them with further general education about their emotional life. Second, if they complete the assignment associated with this activity, they may be able to have a positive effect on another person’s mood:

JSF:     I want to tell you another interesting thing about moods. They’re contagious. Do you  know what contagious means? It means that you can catch them from being around other  people who are in bad moods or good moods. Like when you got here. I noticed your  mom was in a pretty bad mood too. It made me wonder, did you catch the bad mood from    her or did she catch it from you? Anyway, now you seem to be in a much better mood. And so I was wondering, do you think you can make your mom “catch” your good mood?

S:         Oh yeah. I know my mom pretty well. All I have to do is tell her I love her and she’ll get all mushy and stuff.

JSF:     So, do you love her?

S:         Yeah, I guess so. She really bugs me sometimes though, you know what I mean?

JSF:     I think so. Sometimes it’s especially easy for people who love each other to bug each other. And parents can be especially good at bugging their kids. Not on purpose, but they bug you anyway.

S:         You can say that again. She’s a total bugging expert.

JSF:     But you did say you love her, right?

S:         Yeah.

JSF:     So if you told her “I love you, Mom,” it would be the truth, right?

S:         Yeah.

JSF:     And you think that would put her in a better mood too, right?

S:         No duh, man. She’d love it.

JSF:     So, now that you’re in a better mood, maybe you should just tell her you love her and spread the good mood. You could even tell her something like: “Dude, Mom, you really   bug me sometimes, but I love you.”

S:         Okay. I could do that.

It’s obvious that Sam knows at least one way to have a positive influence on his mother’s mood, but he’s reluctant to use the “I love you” approach. In this situation it would be useful for Sam to explore alternative methods for having a positive effect on his mother’s mood.

Although some observers of this therapy interaction may think the counselor is just teaching Sam emotional manipulation techniques, we believe that viewpoint makes a strong negative assumption about Sam and his family. Our position is that successful families (and successful marriages) include liberal doses of positive interaction (Gottman et al., 1995). Consequently, unless we believe Sam is an exceptionally manipulative boy (i.e., he has a conduct disorder diagnosis), we feel fine about reminding him of ways to share positive (and truthful) feelings with his mother.

To spread a good mood requires a certain amount of empathic perspective taking. Often, youth are more able to generate empathic responses and to initiate positive interactions with their parents (or siblings, teachers, etc.) after they’ve achieved an improved mood state and a concomitant increased sense of self-control. This is consistent with social–psychological literature suggesting that positive moods increase the likelihood of prosocial or altruistic behavior (Isen, 1987). Because of developmental issues associated with being young, it’s sometimes helpful to introduce the idea of changing other people’s moods as a challenge (Church, 1994).  “I wonder if you have the idea down well enough to actually try and change your mom’s mood.”

Once in a while, when using this technique, we’ve had the pleasure of witnessing some very surprised parents. One 12-year-old girl asked to go out in the waiting room to tell her grandmother that she was going to rake the lawn when they got home (something Grandma very much wanted and needed). Grandma looked positively stunned for minute, but then a huge smile spread across her face. The girl skipped around the office saying, “See.  I can do it.  I can change her mood.”

One 14-year-old boy thought a few minutes, then brought his mom into the office and said “Now Mom, I want you to think of how you would feel if I agree to clear the table and wash the dishes without you reminding me for a week.” Mom looked a bit surprised, but admitted she felt good at the thought, whereupon I (John) gave the boy a thumbs up signal and said, “Well done.”

Step 4.

At this point, readers should beware that although we’re describing a Three-Step technique, we’ve now moved to Step 4. We do this intentionally with young clients to make the point that whenever we’re working with or talking about emotions, surprising things can happen.

In keeping with the learn-do-teach model, we ask our young clients to teach the TSPB procedure to another person after they learn it in therapy. One girl successfully taught her younger brother the method when he was in a negative mood during a family hike. By teaching the technique to her brother, she achieved an especially empowering experience; she began to view herself as having increased control over her and her family’s emotional states.

Boys and Men, Personal Reflections

Raising Boys in the 21st Century

Leave a comment

As some of you may already know, yesterday I had a blog piece posted on the American Counseling Association website. The piece was titled, “Boys will be Boys . . . Unless we teach them something Better.” Check it out here, if you like: http://www.counseling.org/news/blog

There’s also much more helpful information on “raising boys” on the internet. One example is this featured blog on the Good Men Project website: “How We Can Improve Sex Ed for Boys.” Here’s the link for that: http://goodmenproject.com/featured-content/the-good-life-how-we-can-improve-sex-ed-for-boys/

I hope you’re all doing well in the run-up (as the Brits would say) to some major holiday activity.

John SF

 

Parenting, Therapy with Adolescents

Why Big Boys Should Cry

4 Comments

As I sit stranded in the Minneapolis airport on my way to the ACA conference in Cincinnati, I remembered that although this blog was posted on the ACA blogsite, I haven’t posted it here yet . . . and so here it is. Feels like it’s about time for a nap.

Why Big Boys Should Cry

By John Sommers-Flanagan

Aaron was asleep on the couch in my office. I decided not to wake him, even though I don’t advocate napping during counseling. But Aaron had just spent several minutes intensely sobbing and unable to speak and so a short nap seemed reasonable.

Experiencing calmness after an emotional storm can be therapeutic. This is partly because holding back strong emotions requires physical effort. When strong sad or painful feelings are present, the body seems to want to naturally express those feelings, as if to unload an extra burden. Holding onto emotions may cause a lump to form in your throat or stinging in your eyes. Letting sad or painful feelings come out can be a great relief.

Research shows that identifying and expressing feelings of sadness, fear, or emotional pain promotes health. This is true whether people write, talk, or nonverbally express emotional pain. The body, unburdened by the need to inhibit or suppress feelings, responds with improved immune functioning.

Generally, boys and men have more trouble acknowledging and expressing painful emotions than girls and women. Some people believe this difference partially explains why males are more violent than females. Others have suggested that inhibiting sad feelings contributes to the fact that, on average, males die younger than females. Most researchers and theorists agree that inhibiting sad, hurt, or fearful feelings is a health liability for boys and men.

It could be argued that biological differences cause males to have more trouble expressing painful feelings (perhaps higher testosterone levels interfere with emotional expression). However, it’s also obvious that boys are systematically taught to inhibit certain feelings. For example, one study showed that mothers—yes, even mothers—were less emotionally responsive to baby boys than baby girls. There also are many gender-based emotionally hardening edicts present in our society, summed up in the old expression: “Big boys don’t cry.” The message to boys is loud and clear: To be accepted, you need to walk, talk, and act like a man (which does NOT include crying because you’ve gotten your feelings hurt).

For boys and men, it’s socially acceptable to experience and express anger, instead of sadness, fear, or hurt feelings. Male teens I work with often brag that they DON’T cry—they just get angry or seek revenge. They’re thoroughly socialized and proud of it. In an interesting contrast, I’ve talked with men who tell me—with regret and not pride—that they haven’t cried for 20 (or more) years. They worry about their inability to cry and speak of it as a loss. The spigot, having been closed so many years ago, feels rusted shut. They want to cry, but don’t know how.

It’s sad that society does this to boys. But it’s especially sad when parents, sometimes inadvertently, other times intentionally, discourage boys from experiencing and expressing emotional pain. It’s also sad when boys are encouraged to be aggressive—instead of sensitive (because, as you know, boys not only will be boys, they must be real boys). Instead, parents need to be a safe haven for the full range of their son’s emotions.

The following suggestions may be helpful to parents who want their boys to learn that big boys should cry.

  • Don’t be afraid that if your son cries, he will turn out to be a sissy.
  • Let your sons cling to you—to both mother and father—for comfort and security. They’ll grow up and distance themselves from you on their own. There’s no need to push them away.
  • When your son looks distressed and you ask him how he’s doing, he’ll often respond by saying: “Fine.” If so, continue to be gently curious. Keep listening. Let him know you’re interested. For boys, the first few “Fine” responses are often a defense against their emotions.
  • Spend time with your sons. Do active things together. Boys often talk best when they’re hiking, biking, hunting, fishing . . . or cleaning the kitchen.
  • Never let there be any doubt in your son’s mind that you love him.

Because of society’s harsh condemnation, when boys or men cry, it can be a harrowing experience. Years ago, I worked with Michael, a Vietnam veteran. He was macho and angry. He told me of a 60 Minutes episode about how Vietnam vets were never welcomed home by American citizens. He was pissed about how his country had treated him.

At the end of the hour, I stood up, reached out, shook his hand, looked him in the eye, and said, “Welcome home Michael.” In response, his anger melted away, his eyes filled with tears, and he fell forward and gave me a short hug. Later, he told me he was ashamed of this embarrassing emotional outburst.

Everyone in our society needs to be open to loving and hugging our boys. We need to let them cry openly and without shame. No one should feel ashamed to experience natural feelings of hurt or sadness. Boys should be helped to accept and experience their feelings. They shouldn’t have to go to counseling to learn to cry again.

**********************************

John Sommers-Flanagan, Ph.D. is a counselor educator at The University of Montana. You can follow his personal blog at johnsommersflanagan.com