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For Therapists: Creative Ways to Use the Emotions List With Emotionally Neglected Clients

How do you help an emotionally neglected (CEN) client, who grew up with their feelings ignored or suppressed, learn about emotions and how they work? 

In the process of talking, writing, and teaching about Childhood Emotional Neglect or CEN, I have had many wonderful opportunities to talk with hundreds of therapists about their experiences and challenges treating CEN clients.

If you are a CEN therapist, I want to start by thanking you from the bottom of my heart. You are helping me reach my longstanding goal of providing CEN therapy to everyone throughout the world who needs it.

If you are not yet a CEN therapist, I hope that you might consider it. I am trying to make CEN therapy available to everyone who needs one.

As it stands right now, there are hundreds of therapists from all over the world listed on the Find A CEN Therapist List.

Despite the healthy numbers, more CEN therapists are clearly needed. Every day, I receive emails from people with CEN who are upset because they cannot find a CEN specialist to help them.

Throughout these few years of training therapists in the treatment of CEN, one major challenge stands out. How do you help a CEN client learn about emotions and how they work? 

Believe me, I understand this problem all too well. Since clients who grew up with their feelings ignored have their emotions walled off as a defense mechanism, they not only view their emotions as useless, harmful, or weak, they also have likely not learned some of the most basic aspects of how feelings work.

Getting a CEN client to talk about feelings in session can seem almost impossible. So how can we teach them about something they are so repelled by and try to avoid at all costs?

Over the last couple of years, one tool has begun to stand out to me as I struggle with this problem in my own work. It’s the Emotions List from the back of my first book, Running On Empty. I use it in multiple different ways that tailor to what a particular client needs. It allows us to start right where they are and get on the healing path that I know has the potential to help them enormously.

Ways to Use the Feelings List With Your CEN Clients

1. The Homework/Process — Tailor it To Your Client

  • Read through the list with your client in session and discuss with them which words they relate to or respond to.
  • Each day, choose a word from the list and use it at some point that day. This helps increase their vocabulary of emotion words and also requires them to have feelings on their mind.
  • Ask the client, when having a feeling, to use the list to help them identify and name what they are feeling.
  • Read one particular category of words or the entire list before the next session.
  • Read the list and pay attention to any words that you connect with and highlight those words as you go through. Bring the highlighted list back so we can go through it together.
  • In couple’s therapy, if an emotion word keeps triggering a spouse, have the one using the word go through the list to find a less-triggering word to use. For example, they may change “You scare me when you…” to “I feel vulnerable when you…”

2. What Was Your Client’s Experience of Doing the Homework?

  • Did they balk or “forget?” You can point out avoidance/discomfort with feelings.
  • How did the client feel while doing it? Was it really hard for them? Why? This opens up a discussion about their relationship with their own feelings and the feelings of others.

3. Look for Patterns in Your Client’s Highlighted Words

  • Only negative or only positive words?
  • None in the anger category or only mild ones like annoyed or irritated indicates their anger is especially repressed.
  • A high concentration of words in one category.
  • All very commonly used or generic types of words like “Anxious” or “Depressed.” I often explain that anxiety and depression are not feelings, but states. Then push them to identify the actual specific feelings that go into the anxiety or depression.
  • A word is missing that you see the client feel a lot.

4. Identify Your Client’s Core Feeling

  • What feelings did your client feel the most during their childhood?
  • Is there a high concentration of words in one category?
  • A word that your client says they have so often that it defines them?
  • A word that seems to characterize much of their childhood experience?

Some General Points About Using the Feelings List

Reuniting our CEN clients with their feelings is one of our greatest challenges. I find that there is something about the Feelings List that, even though it’s very long, feels manageable, and maybe even comforting to these clients.

Perhaps the notion that feelings can be labeled offers assurance that feelings are real and identifiable and understandable.

Each of the ways to use the list described above is a jumping-off point for you and your client to talk about emotions.

Special Point: Identifying a client’s core feeling — the feeling they felt most in their childhood — can be almost like a pipeline to their other feelings. I will write another blog about this process and how to use it in CEN therapy so watch for that.

I’m sure there are many other ways to use the Feelings List in CEN treatment that we have yet to discover. If you have some thoughts about this, I would love for you to share it! Just post it in the Comments section of this blog.

I would love for you to take my 2-CE therapist training, Identifying & Treating Childhood Emotional Neglect: An Overview. Learn about it here: https://drjonicewebb.com/treating-cen/.

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 her to read your favorite book on how to be assertive, and use role-playing to teach her how to share her feelings with the people in her 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.

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.