Group Discussion Questions for the Book Running On Empty: Overcome Your Childhood Emotional Neglect

Since the release of the books Running On Empty: Overcome Your Childhood Emotional Neglect and Running On Empty No More: Transform Your Relationships, people all over the world have been forming book groups, forums, family discussions, and Meetups to discuss them.

When you are working through the effects of Childhood Emotional Neglect (CEN) on your adult life, whether you are working with a CEN therapist or on your own, it is incredibly helpful to have support.

When another person talks about their own CEN childhood, their struggles to understand emotions and how they work, or the discomfort of a visit with their emotionally neglectful parents, it is validating and informative.

When you talk about your CEN experiences and struggles with others who share your pain, you learn about yourself, and you realize you are not alone.

After being asked many times to offer discussion questions for each book, I have finally created them.

Recommended Format for Discussion Groups

1. Some of these questions are deeply personal, and not everyone will be comfortable answering every question. In the first meeting, decide together which questions or sections you might want to skip as a group. 
2. If there’s no full agreement on which questions to skip, then proceed with all questions with the understanding that any member of the group can choose not to answer any question without any explanation needed.
3. I recommend you take the sections and the questions in order. Go through and have one person read the question and have each member answer it, one at a time with no interruptions.
4. After each member has answered a question, take some time for group discussions, questions and reactions.
5. If your group is live and wishes to be more structured, set a timer to limit discussion time so that you can move to another question. I highly recommend this but it’s not right for every group.
6. If you feel your group needs a leader, one can be assigned who is approved by all members.

Discussion Questions for the Book Running On Empty: Overcome Your Childhood Emotional Neglect

Parents

• Compare “The Ordinary Parent in Action” described in Chapter 1 with your parents. How did they compare?
• Which category of emotionally neglectful parents describes your parents the best?
• Were your parents neglected themselves when they were growing up? If you are not sure, can you find out?
• Many people gloss over thinking about their parents and holding them accountable by saying, “They meant well” or “They tried their best.” Can you say this without a doubt, about your parents? Were your parents truly well-meaning?
• What did your parents teach you about emotions and how they work?

CEN Struggles

• Of the 10 characteristics described in Chapter 3, “The Neglected Child, All Grown Up,” what would you say are your top 3 CEN struggles?
• Describe a way that each of these struggles challenges you in your daily life.

Ability to Change

• Of the 3 Factors That Get in the Way of Successful Change (Chapter 5), which apply to you? How do you foresee these factors getting in your way?

About Emotions

• How hard is it for you to believe that feelings have value and a purpose?
• How good are you at identifying and naming your feelings?
• Do you believe that you can trust your feelings?
• Do you often feel guilty, ashamed, or rejecting of your own feelings?
• Which step of the IAAA is the hardest for you?

Relationships

• Of the 7 False Beliefs About Relationships described in Chapter 6, which have been a part of your life?
• Describe a way in which these false beliefs have affected your relationships with family, friends and partners.
• How good are you at vertical questioning? Does it come naturally to you or is it a skill you will need to work on?
• Do you believe that sharing a problem with the right person could be helpful? Or do you worry that others will use it against you?
• On a scale of 1-10 how assertive are you?

Self-Care

• Of the 4 areas of self-care described in Chapter 7, which are your greatest challenges?
• Are you afraid of becoming guilty if you pay more attention to yourself and your own feelings and needs?
• Is it possible for a CEN person to become selfish?
• Do you often find yourself “going along” instead of stating your own wishes?
• Is it hard for you to even know what you want?
• How important is it for you to have fun?
• Do you habitually focus on other people’s needs over your own?

Parenting, Marriage and Your Own Emotionally Neglectful Parents

• These 3 topics are covered in-depth in the book Running On Empty No More: Transform Your Relationships With Your Partner, Your Parents & Your Children.
• Watch for a separate post with questions for Running On Empty.

Fuel Up For Life

If you are interested in joining an ongoing, structured and supportive Childhood Emotional Neglect recovery group online that is created and run by Jonice Webb, Ph.D., CLICK HERE learn more about Fuel Up For Life.

To learn more about Childhood Emotional Neglect, see my first book Running on Empty. 

The 5 Elements of Deep and Meaningful Personal Change

People don’t change.

How many times have you heard someone say that?

Several years ago a woman came to my office asking for help with an extramarital affair that she was having. In an attempt to help her sort it out I began talking with her about why, when, how; her own feelings and needs, her marriage, and her family history. We had a number of meetings in which I worked very hard to help her figure out what to do about it, and how she might handle ending the affair and beginning to repair her marriage (which is what she said she wanted).

Over time though, I started to see that our work was not producing any relief or help to her. My questions did not spur further thinking on her part, and my suggestions seemed to fall on deaf ears.

Finally, after about six visits, she said something very telling to me which stopped the treatment cold. She said, “People don’t change.”

Further exploration of her comment revealed that she was extremely entrenched in this notion. She wanted to come to see me only to vent and receive support; she did not see that she had the ability to change herself or her situation.

Since that time I have encountered many people who resist the idea that they can actually change themselves. And I have noticed that the less aware you are of yourself and your feelings, the harder it is to envision yourself changing. Why are you unaware of yourself and your feelings? It’s quite often the result of Childhood Emotional Neglect or CEN, which is growing up in a household that does not address the feelings of its members.

If you experienced Childhood Emotional Neglect, you are likely focused outward, on other people and their needs, leaving you out of touch with yourself, your emotions, and the sense of self-mastery that other people enjoy.

The 5 Key Elements of Change

1. Awareness: seeing the problem. For example, “I have a problem with my temper.”

2. Commitment: making a clear decision that you want to change. For example, “I’m going to improve my temper.”

3. Identifying the Steps: For example, a) become more aware of my anger; b) learn how to control my anger; c) learn how to express anger in a healthy way.

4. Doing the Work: While changing ourselves is definitely possible, it is usually not easy. That’s why awareness, commitment and breaking it down into steps become so vital.

5. Asking for help: from spouse, friend, family or a therapist.

Here is a tiny sampling of the myriad ways that I have seen people change themselves:

• A woman gets her defenses down and is able to receive feedback from her husband and act upon it, on a regular basis.
• A teenager vows to stop smoking pot and makes it happen.
• A man stops himself from yelling at his children by learning new parenting skills and using those instead.
• A woman who was emotionally neglected in childhood learns how to accept and express her feelings and needs, and starts speaking up for herself with her husband, family, and friends.
• A man decides he is tired of feeling anxious. He explores its sources in his life and learns new anxiety management techniques. As a result, he becomes more sociable and outgoing and more willing to take risks at work.

I could go on and on, but you get the idea. The possibilities are endless. True, some things are more difficult to change than others. And some people have more difficulty changing themselves than others. For example, a personality or temperament issue will be difficult to change in a different way than a habit.

But in my experience from working with many hundreds of people to change many hundreds of issues, I can tell you without a doubt that the two biggest factors in whether you can change are:

Really, really wanting it.

And believing that it’s possible.

To learn if you grew up with Childhood Emotional Neglect, Take the Emotional Neglect Test. It’s free. And see the book Running on Empty: Overcome Your Childhood Emotional Neglect.

A version of this article first appeared on Psychcentral.com. It has been reproduced here with the permission of the author.

5 Unique Things People With Childhood Emotional Neglect Need From Their Therapists

Consider this brief exchange from Abby’s therapy session:

Abby grew up with Childhood Emotional Neglect, but neither she nor her therapist is aware of this. Abby has begun therapy with Dr. Simmons because her PCP became concerned that she might be depressed and referred her.

Abby: I don’t know what my problem is, Dr. Simmons. I should be happy to see my parents, but every time I go there all I want to do is leave.

Dr. Simmons: What exactly happened while you were there on Sunday? Something must be happening that makes you want to get out of there.

Abby: We were sitting around the table having roast beef for Sunday dinner. Everyone was talking, and I just suddenly wanted to get the hell out of there for no reason at all.

Dr. Simmons: What were you all talking about? Something about the topic must have upset you.

Abby: We were discussing regular topics, nothing upsetting. The weather, the increased traffic in our area, my parents’ trip to China. Same stuff we usually talk about.

Dr. Simmons: Did anyone say something hurtful to anyone else?

Abby: Not unless “It took me an hour to drive 5 miles yesterday,” could be considered hurtful.

Abby and Dr. Simmons have a good laugh together. Then they go on to talk about Abby’s new boyfriend.

Childhood Emotional Neglect

Childhood Emotional Neglect happens when your parents fail to respond enough to your emotions as they raise you.

Abby grew up in a family that did not notice, validate, or talk about emotions. Sensing that her feelings were useless and troublesome to her parents she, as a child, walled off her feelings so that she would not have to feel them.

Now, as an adult, Abby lives with a deep emptiness that she does not understand. She senses something missing where her emotions should be. She is living without full access to the font of energy, motivation, direction, and connection that her feelings should be offering her if only she would listen.

And, although Abby does not know it, she has lived through countless family dinners and myriad moments and days of vacuous, surface family interactions where nothing of substance was discussed, and anything that involved feelings was avoided like the plague.

In reality, unbeknownst to both therapist and client in this scenario, Abby is not actually depressed. She only seems depressed because she is not able to feel her feelings. And Abby didn’t “feel like leaving” the family dinner because someone said something hurtful. She actually felt overlooked, invisible, bored, and saddened by what’s missing in her family: emotional awareness, emotional validation, and meaningful conversation.

But she has no words to express this to Dr. Simmons. And Dr. Simmons, unaware of the syndrome of Childhood Emotional Neglect, does not know to ask about it.

Every day, I get messages from CEN people who are disappointed that their therapy is not addressing their Childhood Emotional Neglect. Even if they are pleased with their therapist, and also with many aspects of their therapy, they still feel that, in some important way, they are missing the mark.

Having talked with, or heard from, tens of thousands of CEN people, I would like to share with you exactly what CEN people need from their therapists.

5 Special Things People With Childhood Emotional Neglect Need From Their Therapists

Number 1: To finally be seen.

Growing up in a family that does not respond to your feelings leaves you feeling, on some level, invisible. Since your emotions are the most deeply personal expression of who you are, if your own parents can’t see your sadness, hurt, fear, anger, or grief, you grow up sensing that you are not worth seeing.

Tips For Therapists: Make a special effort to notice what your client is feeling. “You seem sad to me,” for example. Talk about emotions freely, and ask feeling-based questions. Dr. Simmons’ question about the topic of conversation yielded nothing. A fruitful question might have been, “What were you feeling as you sat at the table?” When you notice, name, and inquire about your client’s feelings, you are communicating to your client that her feelings are real and visible, which tells your client that she is real and visible.

Number 2: To be assured that their feelings make sense.

Growing up with your feelings under the radar, you learned to distrust and doubt that your feelings are real. As an adult, it’s hard to believe in your feelings or trust them.

Tips For Therapists: As you notice your client’s feelings, it’s also essential to make sure you understand why he feels what he feels. And then to validate how his feelings make sense to you and why. This will make them feel real to him in a way that they never have before.

Number 3: To learn who they are.

How can you know who you are when you are cut off from your own feelings? CEN adults are often unaware of what they like and dislike, what they need, and their own strengths and weaknesses.

Tips For Therapists: Your CEN client needs lots and lots of feedback. When you notice something about your client, feed it back to him, both positive and negative — with plenty of compassion and in the context of your relationship with them, of course. This might be, “I notice that you are a very loyal person,” “You are honest, almost to a fault,” or “I see that you are very quick to give up on things.” Your CEN client is hungry for this self-knowledge and you are in a unique position to provide it.

Number 4: To be forced to sit with emotions.

Your emotionally neglectful family avoided emotions, perhaps to the point of pretending they didn’t even exist. Therefore, you have had no chance to learn how to become comfortable with your own feelings. When you do feel something, you might find it quite intolerable and immediately try to escape it. Just as your parents, probably inadvertently, taught you.

Tips For Therapists: Be conscious of your CEN client’s natural impulse to avoid feelings (Abby did so by cracking a joke, which worked quite well with Dr. Simmons). Continually call your client on emotional avoidance, and bring her back to feeling. Sit with that feeling with her as much and as often as you can.

Number 5: To be taught emotion skills.

Growing up in your emotionally vacant family, what chance did you have to learn how to know when you’re having a feeling, how to name that feeling, what that feeling means, or how to share it with another person? The answer is simple: Little to none.

Tips For Therapists: As you name your CEN client’s feelings and continually invite her to sit with them together, it’s also very important to teach the other emotion skills she’s missed. Ask them to read your favorite book on how to be assertive, and use role-playing to teach her how to share their feelings with the people in their life. Freely use the Emotions Monitoring Sheet and the Emotions List in the book Running On Empty to increase her emotion vocabulary.

Why We Need More CEN Trained Therapists

As more and more people become aware of their Childhood Emotional Neglect, more are seeking therapists who understand the CEN they have lived through and are now living with. On my Find A CEN Therapist Page, I am referring clients all over the world to CEN therapists near them. 650 therapists are listed so far in locations all over the world. Yet the demand is great and growing and more CEN-trained therapists are needed!

As a therapist, once you learn about this way of conceptualizing and treating your clients, your practice will be forever changed.

To learn much more about healing Childhood Emotional Neglect and other topics join my Free CEN Breakthrough Video Series!

Therapists, I invite you to join my CEN Newsletter For Therapists. If you take either my 2 CEU therapist training, Identifying & Treating Childhood Emotional Neglect, or my 12 CEU Fuel Up For Life therapist training you can apply to be listed on my Find A CEN Therapist Page. I will send you referrals.

4 Ways Childhood Emotional Neglect Can Take a Toll on Your Physical Health

In recent years, medical and psychological journals have been exploding with studies showing the close relationship between our bodies and our minds.

Study after study shows that the way we think and feel each day has a powerful effect on our health.

For example, carrying around negative feelings (like sadness, anger, hurt, or stress, for example), has been shown to increase the amount of inflammation in your body, which then affects the strength of your immune system which makes you more vulnerable to getting sick. — Jennifer E.Graham-Engelanda, et al.; Brain, Behavior and Immunity, 2018.

Another important study showed that people who are better at regulating their feelings, or in other words managing them, have overall better physical health than people who are not skilled in this way. — Yiying Song, et al., Social Cognitive & Affective Neuroscience, 2014.

And yet another study that looked at how couples argue confirmed what has been shown in multiple other studies: being prone to angry outbursts makes you more prone to cardiovascular problems; and holding in your anger or hurt feelings in a conflict, (the researchers call this stonewalling) over time, is highly associated with back and muscular problems. — Robert Levenson, et al., Emotion, 2016.

This is only a very tiny sampling of the large body of research that proves the close relationship between how you treat your feelings and many aspects of your physical health.

This, of course, begs the question: Why aren’t we all actively trying to get better at managing our emotions so that we can improve our physical health? What’s stopping us? What is in the way?

As a psychologist, just like other therapists, I face these questions every single day. I see how people struggle with their own emotions, and I watch the effects of it all.

I also see that the most common reason people struggle with their feelings so much is Childhood Emotional Neglect or CEN.

Childhood Emotional Neglect (CEN)

Childhood Emotional Neglect (CEN) happens when your parents fail to respond enough to your emotions as they raise you. It is common and even happens in loving homes.

We are all born with our emotions biologically hardwired into us. They emanate from the base of our human brains and travel through special receptors into and through our bellies.

We all have emotions, whether we like it or not. We cannot choose to have feelings or not have feelings, and we cannot choose what we feel.

This is why, if you grew up with CEN, you may be unknowingly living with the effects of CEN, destined for physical problems that you could have prevented if only you had known.

Don’t be worried as you read this. Because you are about to know. And once you know, you can reverse it all.

3 Ways Childhood Emotional Neglect Harms Your Physical Health

1. Internalization of anger can cause heart problems. As the Levenson study above shows, holding in your anger takes a toll on your heart. If you grow up in a household that is intolerant of your anger, ignores your anger, or fails to name, discuss or validate the reasons for your anger, you learn only one way to deal with it: wall it off. This may allow you to cope as a child, but it can harm your heart.
2. Sensitivity to stress can cause back problems or headaches. What makes you sensitive to stress? Not dealing with your feelings. When you wall off your fear, your insecurity, your uncertainty, your anger, sadness, or hurt, those feelings do not go away. They simply pool together on the other side of the wall, waiting for something to touch them off. Then, when it happens, they all surge at you, making you feel overwhelmed and stressed. So going through your life with your feelings blocked makes you more sensitive to stress.
3. Lack of self-awareness makes you vulnerable to poor habits. Families who don’t notice what their child is feeling miss getting to know their child on a deeply personal level. So they sadly remain unaware of who their child really is. I have seen, over decades of treating Childhood Emotional Neglect, that if your parents don’t see you, you do not learn that you are worth looking at. You grow up to be unaware of your own needs, and deep down you don’t realize that your needs even matter. You then are vulnerable to eating or sleeping too much or too little, drinking too much, or engaging in other behaviors that can harm your health.

3 Steps to Stop Childhood Emotional Neglect (CEN) From Harming Your Health

1. Start paying attention to your feelings as you go through your day.
2. Learn more emotion words and make an effort to use them, including naming your own feelings see the book Running On Empty: Overcome Your Childhood Emotional Neglect for an exhaustive list of feeling words).
3. As you do steps 1 and 2 you will start to feel more. Now it is time to begin to actively take charge of your feelings. Work on learning the emotion skills: tolerating, identifying, and expressing your feelings.

As a therapist who specializes in Childhood Emotional Neglect, I help people stop allowing their unmanaged emotions to damage their lives and health every single day.

I have watched people go from a near-complete lack of awareness of their emotions and a deeply held belief that they don’t matter to not only feeling their feelings but being aware of them and actively managing them.

Amazingly, once we allow ourselves to feel, along comes with it a sense of being a real person with real needs, wants, opinions and value.

A real person who matters, and whose health matters. Someone who is worth caring for. And someone who cares.

Childhood Emotional Neglect can be invisible and unmemorable so it can be hard to know if you have it. To find out, see the author’s biography below this article for a link to Take the free Emotional Neglect Test.

To learn much more about how to feel your emotions and show yourself better self-care, see the books Running On Empty: Overcome Your Childhood Emotional Neglect and Running On Empty No More.

How to Know the Difference Between Selfishness and Strength

Let’s start with a little test to see where you are on this.

Selfishness Quiz

Read through this list of personal actions, and label each as either “strong” or “selfish.”

1. Your elderly aunt asks you to take her out to dinner and you say no because you have to get home to your children.
2. Your elderly aunt asks you to take her out to dinner and you say no because you are really tired, and need to go home and get some rest.
3. Your elderly aunt asks you to take her out to dinner and you say no because you don’t want to miss the Red Sox game on TV.

If you answered “selfish” to all three:

Chances are, you are highly uncomfortable with saying “no” under any circumstances. You are governed by guilt, and you believe that your own needs are less important than those of others.

If you answered “strong” to:

Number 1: You are able to be strong, at least for the sake of your children. If you are saying no for the sake of your children, you are putting their needs before your elderly aunt’s, and that is a judgment call. Who needs you more right now? If it’s your children, then being able to say “no” to your aunt is a sign of strength.

Number 2: Saying no because you are tired could very well represent strength. If you get enough rest for yourself, you will be in better shape to take care of others. It’s an example of putting your own needs first, which makes it easier for you to contribute to the world in a positive way.

Number 3: You could potentially be crossing the line over to selfish here. Is the Red Sox game truly more important than giving your elderly aunt an outing? Unless there are some mitigating circumstances, you may be making a self-centered choice here. This one may require some careful self-reflection.

In truth, the line between selfish and strong is blurry at best. For example, saying no because of the baseball game may not represent selfishness if you need to be able to talk about it intelligently at a sales meeting the next day, or if your aunt asks you to dinner more often than you can comfortably accommodate in your life. Or saying no because of your children could be selfish if it’s really because you would enjoy being with your children more than dinner with your aunt.

Few people are purely selfish or strong. Most of us struggle with decisions like these all the time. Many people feel selfish and guilty for the simplest personal choices which are actually healthiest and best for them or their families. Sometimes we err too far toward selfish; at other times we give too much because of fear of being so. Often a decision which appears selfish is not, and strong decisions can sometimes come across as selfish to others.

The Role of Childhood Emotional Neglect

If you have a tendency to feel guilty or selfish when you put your own needs first, it may be because you were emotionally neglected in childhood. Emotional Neglect happens when parents either purposely or unwittingly give a child the message that his feelings and emotional needs are irrelevant. The unspoken message is: “Your needs don’t matter.”

Children who grow up this way, once they become adults, have great difficulty viewing their own needs as important enough to trump anyone else’s. They feel guilty valuing or emphasizing what they want, feel and need. This is an important quandary since emotional health requires us to take care of ourselves first.

Guidelines for Making Sure You are Strong, Not Selfish

1. Be thoughtful in your personal decisions.
2. Take your own health and wellness into consideration with every decision. You are the guardian of your own needs. You have a responsibility to care for yourself physically and emotionally.
3. Consider others’ needs and feelings and weigh them against your own.

Do you worry that you are selfish? Truly selfish people don’t usually struggle much. They easily make the decision that’s best for themselves. They don’t think too much about it, and they don’t look back.

If you follow the above guidelines, you will be strong. Because, in the end, for each and every decision that you make in your life, your strength comes from the fact that you cared enough to think it through.

Strength comes not from putting another’s needs before your own. Instead, it comes from the simple act of weighing another’s needs against your own.

To learn more about Childhood Emotional Neglect, and how to place greater value on your own feelings and needs, Take the Emotional Neglect Test and see the book Running on Empty. 

A version of this article first appeared on Psychcentral.com. It is republished here with the permission of the author.

Childhood Emotional Neglect: A Guide For Therapists & Clients

Childhood Emotional Neglect (CEN) happens when your parents fail to validate and respond to your emotions enough as they raise you.

Growing up this way leaves you with some significant challenges throughout your entire adult life.

As I have said many times before, Childhood Emotional Neglect (CEN) can be healed. Even beyond that, therapists and laypeople alike are realizing that taking the steps to heal CEN is a powerful way to change your life from the inside.

One of my greatest goals in writing and speaking and teaching about Childhood Emotional Neglect is to give both mental health professionals and CEN sufferers a common language to talk about what failed to happen, the gaps that are left by that, and what it takes to fill them.

This route to healing is both validating and compelling for those who grew up with Emotional Neglect. And more and more therapists are finding that walking their clients through the 4 CEN Recovery Steps is remarkably rewarding work.

For Clients

Looking For a CEN Trained Therapist?

If you are looking for a therapist who is familiar with the CEN concept and is trained in the recovery process, see my Find A CEN Therapist Page. It lists almost 500 licensed therapists located all over the world who have either read my books or have attended one of my CEN Therapist Continuing Education Trainings. And if there are none located in your area, many of the therapists on the list do Skype treatment.

Want Your Therapist to Learn About CEN?

If you are in treatment with a therapist who is not trained in treating Childhood Emotional Neglect, you can share this article with your therapist as a way to introduce him or her to the CEN concept and the kind of work you would like to do together.

About Childhood Emotional Neglect — For Therapists

• Your client may have read self-help books, or even seen other therapists in the past. Nevertheless, he/she has found the awareness of Childhood Emotional Neglect deeply validating, and offering answers not found before.
• If you can join your client in this conceptualization of what is wrong, I believe you will find that the CEN concept also offers you both a meaningful path forward in your work together.
• The primary problem is this: Your client grew up in a non-emotionally-aware family. Even though you are quite likely already aware of this, it is important to acknowledge it as the center of what’s wrong for your client now.
• As a child, your client had to wall off their emotions in order to get by in their emotionally empty home.
• Now, as an adult, your client’s emotions remain walled off. CEN adults do not have enough access to the emotions that should be stimulating, connecting, guiding and enriching them through adulthood. They know that something is not right, but they do not know what it is until they find the explanation of CEN.
• CEN adults struggle with a particular pattern of symptoms: emptiness or numbness, a feeling of separateness, a deep sense of being fundamentally flawed, lack of self-knowledge, and low emotional intelligence.

Free Resources For Therapists

Become a CEN Specialist: You can find many more Resources and Tools For CEN Therapists on the For Therapists Page.

Fill out this Brief Form to apply to become a CEN Specialist and get listed on the Find A CEN Therapist Page.

The 4 Steps of Childhood Emotional Neglect Treatment

The treatment of Childhood Emotional Neglect is a process of 4 steps, all of which build upon each other. When you are aware of the natural progression of these steps you will be able to guide your client through them in a meaningful way.

1. Help your client become aware of the exact way that Emotional Neglect happened in her childhood home. The goal is for your client to understand, on a deep level, what she did not get in her childhood (emotional validation, awareness, and skills), and how it has affected her in her adult life.
2. Break down the wall blocking your client’s emotions so that he can begin to have more feelings. Helping your client break down his wall involves exercises of emotional awareness, plus meditation/mindfulness and monitoring practices that consciously attempt to reach and identify emotions, as well as building the client’s emotional vocabulary.
3. Teach your client how to name, tolerate, manage, express, and use her feelings. As your client’s wall begins to break down, he will begin to feel more variety, complexity, and depth of emotions. This is your opportunity to begin to fill in the emotion skills that he wasn’t able to learn in his childhood home. If your client has read the book, Running On Empty: Overcome Your Childhood Emotional Neglect, he will be aware of the special structured exercises to help guide him through this. He will need you to learn about them so you can guide him through this process of learning what to do with feelings.
4. Help your client start applying her newfound emotions to strengthen and deepen her relationships. Since your client has lived without enough access to her emotions, her friendships and relationships are likely either too few, lacking in depth, or both. You can now guide your client into the process of inserting her feelings into her relationships and beginning to change them into something more meaningful and resilient.

For Therapists & Clients

CEN Resources To Assist Your Work Together

• • Take the free Emotional Neglect Test to help you identify or confirm CEN.
  • Attend one of my CEN Recovery Retreats. I will walk you through the exercises to break down your wall and feel your emotions, plus teach you the skills you need to recover. My next Retreat is 8/23/19 at the 1440 Multiversity in Scotts Valley, CA. Sign up soon because space is limited!
  • Download the CEN treatment exercises and the Feeling Word List from the book Running on Empty: Overcome Your Childhood Emotional Neglect.
  • Download the Worksheets For emotion skills and relationship-building from the book Running On Empty No More: Transform Your Relationships With Your Partner, Your Parents & Your Children.
  • Join the intensive CEN Recovery Program Fuel Up For Life. I designed this intensive program to provide the structure, tools, and information that therapists and clients can use in their work together.
  • Special Note for therapists: I have created a 2 CE Credit CEN Training Overview and a special version of Fuel Up For Life for therapists. Join my CEN Therapists Newsletter to learn how to sign up for them.

CEN Therapist List: Clients can find a CEN trained therapist near them. If you are a therapist, you can request to be added to the list to receive more referrals of CEN folks, which I am sure you will find to be some of the most rewarding people to work with.

Running On Empty: Overcome Your Childhood Emotional Neglect: This book presents the concept of CEN in depth to readers, how it happens, why it can be so unmemorable, and how it affects the child, plus many aspects of the recovery process. It also has a special chapter for therapists.

Running On Empty No More: Transform Your Relationships With Your Partner, Your Parent & Your Children: This book is all about how to identify and heal the effects of Childhood Emotional Neglect in couples and families. It also offers lots of specific information for parents on exactly how to emotionally validate and respond to their children. I wrote this book to use as a guide for clients and therapists to go through together. It is especially helpful for Treatment Step 4.

Whether you are a CEN sufferer looking for a therapist who understands you in this deep and meaningful way or a therapist who wants to learn about Childhood Emotional Neglect and how to walk your clients through the 4 Stages of Recovery, there are many answers and resources for you.

One of my biggest goals is to provide a well-trained therapist who is passionate about treating Childhood Emotional Neglect to every man, woman and child everywhere in the world who needs one.

The 6 Step Boundary Building Exercise

What can protect you from toxic people, keep painful memories in their place, keep you safe and strong, and help you manage your feelings?

Boundaries.

Truly, boundaries are amazing. And good ones are a cornerstone of mental health.

When you grow up in a household that has healthy boundaries, you naturally have them yourself as an adult. But unfortunately, many of us don’t start out with that advantage.

If you grew up in a household with Childhood Emotional Neglect (your feelings and emotional needs weren’t met enough), or if you had a parent with a personality disorder, you may be especially challenged in this area.

Without strong but flexible boundaries, you may be overly vulnerable to criticism or insults from others, you may struggle to manage your feelings internally or prone to emotional outbursts, you may find yourself worrying too much, dwelling on the past, or not keeping yourself safe enough.

People with Childhood Emotional Neglect often have an overly rigid Internal Boundary, which blocks off their emotions too completely. So they can come across to others as excessively unflappable, or even emotionally bland.

If one of your parents had a personality disorder, your Internal and External Boundaries may be overly porous, or too flexible, resulting in emotional outbursts and difficulty managing your feelings.

The hallmark of a healthy boundary is strong but flexible.

As adults, one of the best things we can do for ourselves is to understand boundaries and work on building them for ourselves.

The Four Types of Essential Boundaries

• Physical Boundary: This boundary is the easiest to visualize and understand, and has been the most studied. Research indicates that the average American requires about two feet of personal space in front, and 18” behind them to be comfortable. Jerry Seinfeld made this boundary funny when he featured the “close talker” on his show. But actually, the physical boundary is more than just space. It can be violated by people whose touch is unwelcome, or by someone who feels physically threatening to you. Your boundary tells you when to set limits and when to protect yourself, by making you feel uncomfortable.
• External Boundary: This boundary must be strong but flexible. It serves as a filter that protects you from insults and injuries that come from the outside. When you receive criticism at work; when your spouse tells you she’s angry at you; when a driver calls you an obscene name, or when your sister calls you “selfish,” this boundary kicks in. It talks you through what the other person said or did to you and helps you sort out what’s real feedback that you should take seriously, and what you should reject.
• Internal Boundary: This is the boundary which protects you (and others) from yourself. It serves as a filter between your feelings, and what you do with them. This boundary helps you sort through your intense anger, hurt and pain, and decide whether, and how, to express it.
• Temporal Boundary: We all carry our past experiences within us. And we can often tend to dwell on them in a way that is not helpful. On top of that, old feelings often attach themselves to current experiences and emerge when we least expect them. This is why people blow up over burnt toast, for example. It’s also easy to give the future too much power over us. Spending too much time thinking about, imagining, worrying about, or dreading the future can cause anxiety and prevent us from living in the moment. Your temporal boundary senses when you’re going too far back or forward and pulls you back.

I know what you’re thinking: “OK, that’s great. Mine are not so good. How do I make them better?”

Here’s an exercise to help you create and strengthen your boundaries. First, choose one of the above four types that you’re going to build. Then follow these steps:

The 6 Step Boundary Building Exercise

1. Close your eyes, and count to ten in your head, while breathing deeply and calmly.
2. Imagine yourself surrounded by a circle. You are in the exact center, surrounded by the exact amount of space that you feel most comfortable with.
3. Turn the circle into a visible wall. That wall can be made out of anything you like: clear or opaque plastic, bricks, smooth cement or something else. It can be anything you want, as long as it’s strong.
4. Although the wall is strong, you and only you have the power to flex it when you want. You can remove a brick or soften the plastic to allow things inside the wall or out of the wall whenever you need to. You hold all the power. You are safe.
5. Stay inside the wall for a minute. Enjoy the feeling of being in control of your world.
6. Repeat this exercise once-a-day.

Now there’s one more important key to using your new boundary.

Eventually, your boundary will operate naturally. But in the beginning, you will have to consciously use it. It helps, especially in the beginning, to try to anticipate situations in which you will need, and can practice using your boundary.

Let’s say you’re going to visit your parents and you know that, at some point during the visit, your father will make an offhand comment implying that you have disappointed him (because he always does).

For this challenge, you’ll need primarily your External Boundary, to filter out your father’s comment and disempower it. You may also need your Internal Boundary if you want to manage your own response to his comment. So right before you go, sit down and follow the above steps to get your External and/or Internal Boundary firmly in place.

At your parents’ house, wait for your dad’s comment to come. If it does, immediately picture your boundary around you, filtering for you. The filter asks,

What part of this is valuable feedback that I should take in, and what part of it says more about the speaker?

Your boundary tells you this:

None of this is valuable. Your father’s comment is all about him, not you.

And there you are. You hold all the power. You are safe.

Childhood Emotional Neglect can be subtle and invisible, so it can be difficult to know if you have it. To find out Take The Emotional Neglect Questionnaire. It’s free! And to learn much more about CEN see the book, Running on Empty: Overcome Your Childhood Emotional Neglect.

A version of this article was originally posted on psychcentral.com. It is republished here with the permission of the author.

The Difference Between Self-Esteem, Self-Worth, Self-Confidence and Self-Knowledge

I have noticed that there is a great deal of confusion between the four common challenges listed in the title. Sometimes people ask me if they are all the same.

The differences can be subtle and there can be overlap, yes. But they are all indeed different in some very specific ways. Ways that are important to understand as you think about your own view of, and feelings about, yourself.

So let’s start with a little “quiz.” As you read the descriptions below, see if you can identify which person has low self-esteem, which has low self-worth, who has low self-confidence, and who has low self-awareness.

Then read on to see if you identified them correctly, and also to learn much more about each of these common struggles.

Jenny

Jenny sits on the couch in the lobby waiting to be called for her job interview to begin. On the outside, she appears calm and composed. On the inside, she is desperately trying to manage her anxiety and stop the thoughts that are racing through her head.

What if I say the wrong thing? What if they see right through me? I might blow this. I don’t belong here. Around and around those thoughts go, feeding her anxiety.

Dwight

Dwight wakes up at 11:00 this Saturday morning. Lying in bed, he thinks about going straight to the gym to make sure he gets in a workout today. But a dark feeling creeps over him, and he realizes he has already lost this battle. He rolls over and goes back to sleep, wanting to escape this crappy feeling.

Molly

Molly sits with her friends at a restaurant as they all discuss the win/loss record of the Red Sox and whether they are likely to do well this year. As her friends throw around game stats, players’ names and batting averages, she quietly feels mortified. “I can’t even remember the players’ names, much less all these stats. They are all so much smarter than I am.”

Andy

Andy, receiving his 6-month evaluation at his new job, hears his boss say the words, “Your skills with Excel spreadsheets could use some improvement. I’m sending you to an Excel training next week.” His head reeling, he misses the rest of the feedback he receives. He is thinking, “I might as well quit now. This is obviously not the right job for me.”

Now that you have read the experience of Jenny, Dwight, Molly, and Andy above, let’s see how accurately you were able to identify the dilemma of each.

Self-Confidence — Jenny

Jenny’s anxiety is not actually about the job interview. It is about herself. Deep down, Jenny does not believe that she has the ability to present herself well in the interview. She is doubting her own ability and skills. Self-confidence is how much you truly believe in yourself and what you can do.

Self-Worth — Dwight

Dwight knows that he should go to the gym, and he also wants to do so. Surprisingly, that dark feeling that creeps over him is not depression or sadness or grief. It is actually a deep feeling that he is not worth the time, effort and energy that would be necessary to get to the gym. Self-worth is your deeply held feeling about your own value as a person.

Self-Esteem — Molly

Molly feels inferior to her friends as they talk about the facts and statistics of baseball. This is an expression of her low self-esteem. Molly has no idea that she is every bit as intelligent and interesting as the people at the table; she simply knows less about baseball because she is not a fan of the sport. Self-esteem is the way you feel about yourself in different areas, like intelligence, personality, appearance, and success.

Self-Knowledge — Andy

Andy was given lots of good feedback in his evaluation, but he was knocked off his game by the one, small, negative comment he heard. Andy was very hurt by the one small negative statement because he does not know what his strengths and weaknesses are. He doesn’t realize that he brings multiple other strengths to this job that outweigh his lack of experience with Excel. Self-knowledge is how well you know your own abilities, talents, capabilities, preferences, likes and dislikes, wants and needs.

The Ways These 4 Struggles Hold You Back

1. Self-Confidence: Having low self-confidence like Jenny makes it hard to try new things or reach for new challenges. Anxiety is a natural result that holds you back, clinging to the familiar things you do have confidence about, like a job, relationship or living situation, for example.
2. Self-Worth: Low self-worth undermines what you are willing to do for yourself. Are you worthy of another person’s attention and love? Are you deserving of receiving good things? Do you have enough to offer other people so that they might value you? Having low self-worth prevents you from believing in yourself and from claiming what is yours.
3. Self-Esteem: When you have low self-esteem you walk through the world in a one-down position. You operate from a place of, “I’m not good enough.” Everything that happens in your life is filtered through that deeply held notion, even though it is definitely not true. So even mundane interactions like Molly’s, once they go through your filter, can end up hurting you.
4. Self-Knowledge: How well, and how accurately, do you see yourself? Can you predict how you will act, or how you will feel, in certain situations? Are you aware of your own strengths and preferences? Low self-knowledge makes it hard to make good choices for yourself, and hard to believe in the decisions you make.

The Underlying Cause

In my work as a therapist for over 20 years I have clearly seen the main factor that prevents good, strong people from seeing, believing, and owning what is so good and strong about them. It is this:

Childhood Emotional Neglect (CEN): Being raised by parents who fail to see, value, and validate your deepest, truest self — your emotions — enough.

When your parents don’t see your feelings, even if it’s not done maliciously, they fail to see the real you. If they don’t see you, they can’t really know you. If they don’t know you, their love won’t feel deep and real.

I have seen over and over again three very relevant things. First, most people who grew up with Childhood Emotional Neglect have no idea that it happened to them. Second, most of those people continue the neglect by emotionally neglecting themselves. And third, if you don’t see and nurture yourself emotionally, you are very vulnerable to low self-confidence, esteem, worth, and knowledge.

The Answer

Yes, believe it or not, there is one! Now that you are aware of what might be wrong, you are on the path to healing it. By learning to treat your feelings and yourself differently you can change how you feel about yourself in very profound ways. This is the path to healing your Childhood Emotional Neglect.

To learn much more about how Childhood Emotional Neglect happens, why you may not be aware of it, and how to reverse it, see the book Running On Empty: Overcome Your Childhood Emotional Neglect.

To find out if you grew up with Emotional Neglect Take the Emotional Neglect Test. It’s free.

To learn how to heal your adult relationships from Emotional Neglect see the book Running On Empty No More: Transform Your Relationships.

Stop the Self-Blame: Learn Compassionate Responsibility Instead

Accountability and blame are not the same.

Imagine this scenario:

Your good friend Trish calls you upset. “I’m such an idiot,” she says. “I was in a huge hurry to get to a meeting at work, so I backed out of the driveway really fast. I wasn’t paying attention, and I ran right over the mailbox. It destroyed the mailbox and put a huge dent in the back bumper of my car. I’m such a moron!”

Take a moment to think about how you would respond. What might you say to Trish? Would you say:

“Trish, you’ve lived in that house for ten years. Had you not noticed where the mailbox is? What a dolt!”

Or would you be more likely to say:

“Trish, don’t talk like that. Everybody makes mistakes. Don’t be so hard on yourself!”

I’m willing to bet that you would say the second option. Because you would never be as hard on your friend as she is on herself.

Now imagine yourself in Trish’s place. How angry would you be at yourself for making this mistake? What would you say to yourself?

How could I be such a fool?

I’m more trouble than I am good.

I’m a bad person.

Why can’t I learn?

These are comments that many fine people say to themselves when they make mistakes. These kind and caring people would never say anything like that to a friend, a child, a spouse, or anyone for that matter. Let’s see how the above comments come across when directed outward at another person, rather at oneself. Imagine saying these sentences to a friend.

How could you be such a fool?

You’re more trouble than you are good.

You’re a bad person.

Why can’t you learn?

Imagine the damage these comments would do to your friend or spouse, and to your relationship with him or her. That is the damage that you are doing to yourself when you say these things to yourself.

There’s a particular group of people who are more prone to treating themselves so harshly: those who were raised with Childhood Emotional Neglect.

If you were raised by a parent who ignored you and/or your mistakes (an aspect of Childhood Emotional Neglect), you didn’t get to internalize a parent’s voice of Compassionate Responsibility.

 Compassionate Responsibility: holding yourself accountable for your misstep while also having compassion for yourself. Keep in mind that responsibility is not the same as blame.

Here’s what a parent says to her child during a moment of Compassionate Responsibility: “Everyone makes mistakes sometimes. Let’s figure out what you did wrong here and how to prevent this mistake in the future. Let’s learn from this mistake. Then we’ll let go of it and move on.” 

From these few short sentences, this fortunate child is learning the vital life lessons that make up Compassionate Responsibility. She is learning how to keep her own mistakes in perspective; that they are not the end of the world, and that everyone makes them. She is learning that it is possible to learn from her mistakes and that there is no point in dwelling on them. Beyond that, she is internalizing her mother’s (or father’s) voice. Over time, it will become her own. Then it will talk her through all of the mistakes that she will make throughout her life. You can see that there is no blame involved here.

If you were raised by a parent who, for whatever reason, was not able to provide you with this even, reasonable, accountable yet forgiving voice, you may have to develop it for yourself as an adult. Here are some tips to help you:

1. Become aware of the damaging things you say to yourself. Track it by recording each negative, blaming comment you make. Start a special list on your phone, on your computer, or a piece of paper, and try to catch yourself each time. Awareness is the first step to changing it.
2. Focus on compassion. Strive to have the same compassion for yourself that you have for the other people in your life. Imagine that someone you care about made the same mistake you just made. What would you say to them? That’s what you should say to yourself.
3. Follow these steps: When you make a mistake, make a conscious effort to talk yourself through it. What can I learn from this? How can I prevent this in the future? Then put the mistake behind you and move on.

Childhood Emotional Neglect can be invisible and difficult to remember so it can be hard to know if you have it. To find out, Take The Emotional Neglect Questionnaire.

To learn more about Compassionate Responsibility and Childhood Emotional Neglect, see EmotionalNeglect.com and the book, Running on Empty.

A version of this post was originally published on psychcentral.com. It has been reposted here with the permission of the author.

Can Childhood Emotional Neglect Make You Passive-Aggressive?

“Lingering, bottled-up anger never reveals the ‘true colors’ of an individual. It, on the contrary, becomes all mixed up, rotten, confused, forms a highly combustible, chemical compound, then explodes as something foreign, something very different, than one’s natural self.” 
― Criss Jami, Healology

“Passive aggressive behavior is counterproductive. Communication is key to a healthy personal and work relationship.”
― Izey Victoria Odiase

What Does it Mean to be Passive-Aggressive?

“Being marked by, or displaying, behavior characterized by the expression of negative feelings, resentment, and aggression in an unassertive passive way (as through procrastination and stubbornness)” — Merriam-Webster dictionary

6 Examples of Passive-Aggressive Behaviors

• Showing up late
• Making a joke with a hurtful barb in it
• Forgetting something important
• Ignoring
• Canceling a plan
• Behaving irritably while claiming nothing is wrong

All of the events above happen to everyone often, of course. And they are not necessarily examples of passive-aggression unless they are accompanied by, or an expression of, one key factor. Anger.

So now, I ask you to re-read the list above but add the phrase “out of anger, to punish someone” at the end of each one. These common, everyday behaviors now become ideal examples of passive-aggression.

The Role of Childhood Emotional Neglect in Passive-Aggression

We are all born with the emotion of anger wired into us for a reason. It is a feeling that is essential to our survival.

Feelings of anger are nothing more than messages from your body. When you feel angry, your body is saying, “Watch out! Pay attention! Someone or something is threatening or hurting you! You need to protect yourself!”

That’s why anger has a motivational component to it. Anger is an emotion with energy built into it. Think about how anger is often described as fire or passion. It’s an emotion that pushes you to take action.

Legions of children grow up in homes that are intolerant of their anger. Every day, emotionally unaware parents ignore their children’s anger, trump it with their own anger, or send them their children to their rooms for expressing anger. These are all examples of Childhood Emotional Neglect in action.

Childhood Emotional Neglect (CEN): Happens when parents fail to notice, respond or validate their child’s feelings enough.

When you grow up in a home that treats your anger this way, your developing brain and body absorb a powerful and damaging lesson: Your anger is useless, excessive or bad.

As a child, probably without your knowledge, your brain does what is necessary to protect you. It blocks your feelings of anger from reaching your awareness. It virtually walls them off to protect you from this “useless, bad, excessive” force from within you.

What happens then? Several unfortunate things.

1. You lose the ability to fully benefit from this energizing, protective force from within.
2. You do not learn the anger skills you were meant to learn in your childhood.
3. Unprocessed anger does not go away. It sits there, fomenting, on the other side of the wall that your child brain built to block it.

Anger must be felt, understood, listened to and, in many situations, expressed before it goes away. Imagine what happens inside of you when so much fire and energy is left to fester in your body.

The very thing that is meant to empower and protect you instead saps your energy and leaves you more vulnerable. This is not what nature intended.

How Your Unprocessed Anger Can Hurt Others

Unprocessed, walled-off, fomenting anger has a way of finding its way to the surface. This is what puts those who grew up with Childhood Emotional Neglect(CEN) at greater risk than others for behaving passive aggressively.

Believing that your anger is irrelevant and that it is wrong to express it, plus not knowing even how to do so even if you chose to do it, leaves you essentially at its mercy.

So what does a CEN adult do when a friend hurts his feelings, when she’s not given a salary raise she deserves, or when he feels targeted or mistreated? What does a CEN adult do when she senses a conflict brewing or walks into a room where one is already happening?

The answer is, avoid. Avoid letting your anger show, avoid saying anything, avoid the person who has hurt you, or avoid by leaving the room.

But, as we know, this does not make your anger go away. It will now leak around the edges of the block and come out in ways you never expected, possibly at people who do not deserve it. Just like the 6 ways described above or an infinite number of others. And, worst of all, you may not even realize that it’s happening. But many, many other people may.

If you see yourself, or someone close to you in this post, do not worry. There are answers. It is possible to become less passive-aggressive!

4 Steps To Stop Being Passive-Aggressive

1. Start viewing your anger as a helper instead of a burden. Begin to pay attention to when you feel it. Even if you think you’re never angry, I guarantee you that you do. As strange as it sounds, you only need to relentlessly try to feel it.
2. Start learning how to be assertive. Being assertive is expressing your feelings, thoughts and needs to others in a way that they can take it in. Assertiveness is a group of skills that you can learn. And this is a skill that will help you express your anger in moments of hurt, upset and conflict. When you can express yourself, your anger becomes useful instead of leaking around the edges passive-aggressively.
3. Start building your tolerance for conflict. You have spent your life feeling unprepared and overwhelmed by potentially conflictual situations. Your tendency has been to avoid or ignore them. As you welcome your anger and build your assertiveness skills, you can begin to go toward conflict instead of away.  Redefine these difficult situations as opportunities to practice your skills.
4. Start learning all of the other emotion skills too. It’s not just anger. All of your feelings are messages from your body and can help you substantially in your life. Having grown up in a home that ignored or discouraged your emotions (Childhood Emotional Neglect or CEN), you have likely been under attending and undervaluing yours for your entire life. Now, as your view of your emotions shifts, you can harness the energy, direction, motivation, and connection that you were always meant to enjoy.

The process of becoming less passive-aggressive is actually a process of healing yourself. It involves looking inward instead of outward and accepting the most deeply personal expression of who you are: your emotions.

This process may sound hard, but you can do it. Just as thousands of people before you have already done, you can take the steps and walk the path. You can honor your feelings, and yourself, in a way that you never knew was possible. You can learn to express how you feel.