When Clients Can't Connect or Name Their Emotions

ACT
Acceptance
Commitment
Therapy
When Clients Can’t Connect

with or Name Their Emotions
Practical Tips and Insights for Mental Health Practitioners
BY RUSS HARRIS
Author of the bestselling books ‘ACT Made Simple’ and ‘The Happiness Trap’
Contents
3 The Difference Between Emotions and Feelings?
6 What Causes Disconnection from Emotions?
7 Do Clients Have to Connect with Their Emotions?
8 When Clients Don’t Want to Connect with Emotions
9 What’s the Point of ‘Tuning In’ to Emotions?
10 The ‘Kids in the Classroom’ Metaphor
11 Common Benefits of Better Access to Emotions
14 Working ‘Bottom Up’
16 Graded Exposure to Difficult Feelings
17 Recognising & Labelling Emotions
19 What’s the Point of Naming Emotions?
21 The ‘Basic Five’: Sad, Angry, Happy, Afraid, Relaxed
24 Going Further with Noticing & Naming Emotions
25 What About Emotional Numbness?
28 Online Training in ACT
© Russ Harris, 2023 Psychwire.com/Harris 2

?
was that
an emotion?
or a
feeling?
What’s the Difference Between

Emotions and Feelings?
The term ‘feeling’ is poorly defined in English. It may refer to biological
drives – feeling hungry or thirsty – or physiological states – feeling
tired, or sick – or cognitive states – feeling confused or disorientated.
But most commonly – at least, in the world of coaching, counselling,

and therapy – a feeling refers to the physical component of an
emotional state: the sensations we feel in our body.
Speaking very simplistically, what we call an ‘emotion’ is a loose

bundle of physical sensations and cognitions, continually interacting
with each other in a myriad of complex ways.

The physical sensations come from widespread physiological
changes in the body: changes in the cardiovascular, respiratory,
musculoskeletal, endocrine, and both the central and peripheral
nervous systems. And because we can feel these sensations in our
body, we tend to call them ‘feelings’.
However, it’s important to remember, all emotions include cognitions

as an essential, intrinsic component. There’s no such thing as an
emotion without cognition; no such thing as an emotion that only
involves the limbic brain without also involving the cerebral cortex.
Explore any emotion – sadness, anger, guilt, love, etc – and you’ll
find the experience to be rich in cognition. For example, when
experiencing anxiety, we might have thoughts like, ‘It’s not going to
work’, ‘Something bad will happen’ or ‘I can’t stand this’ and so on.
The cognitive component of an emotion

can also include:
memories
a) The name we give to the experience + images
Na
(e.g. do we describe it as ‘anxiety’ or m e
do we talk of feeling ‘nervous’, ‘jittery’,
n ing
‘shaken’, ‘on edge’?) mea
b) The meaning we make of it

(e.g. ‘I feel scared so that means I’m
in danger’)
c) The images or memories that go with it

(e.g. memories of other times you’ve felt
afraid, or images of what you fear).

So, simplistically speaking ... an emotion = a ‘mixture’ of physical
sensations (arising from physiological changes in the body) and
cognitions, continually interacting with each other in complex ways.
Unfortunately, confusion arises because the term ‘feeling’ is

commonly used not only to describe the somatic sensory component
(i.e. the physical sensations) of an emotion, but also as a synonym for
the word ‘emotion’ itself.
For example, when exploring the emotion called ‘anxiety, we

encounter many anxious thoughts and anxious feelings. At the
same time, ‘anxiety’ is commonly described either as a ‘feeling’ or
as an ‘emotion’.

What Causes Disconnection
from Emotions?
Around 10% of the population finds it hard to access their ‘feelings’;
hard to ‘connect with’ or ‘tune in to’ the somatosensory component
of their emotions.
This may be due to:
• Psychological trauma
(the numbing effects of the dorsal vagus nerve)
• Physical trauma or illness

(physical damage to the nerves)
• Medication-induced emotional blunting

(for example, this a serious side-effect of SSRI and
SNRI antidepressants)
• Experiential avoidance
Because these feelings are unpleasant or painful, and you don’t
like or want them, you try hard to avoid contact with them
• In addition to all the above, sometimes a person has simply never

developed the skill of tuning in to feelings in their body. Typically,
such folks find it easy to access the cognitive elements of an
emotion, but not the somatic sensory components. For example,
they might readily identify anxious thoughts, but have great
difficulty tuning in to the physical sensations of anxiety - such as
racing heart, tightness in the chest, lump in the throat, tense jaws,
sweaty hands, a knot in the stomach, and so on.

joy love
prid
e
sham
e guilt I feel nothing ...
Do Clients Have to Connect

with Their Emotions?
Noooooooo! Clients don’t have to do anything! If the client can’t
(or doesn’t want to) connect with their feelings, and this
disconnection is not causing them any major problems or impeding
their therapy goals, then there’s no need to address it.
However, if disconnection from feelings is a problem for the client

(e.g. they complain of feeling numb or empty or dead inside), or it’s
contributing to the client’s issues, or it’s impeding their progress
towards their therapy goals, then we do need to address it.

When Clients Don’t Want to
Connect with Their Emotions
It’s quite common that clients don’t want to connect with painful
feelings, and instead try hard to avoid, escape or get rid of them:
experiential avoidance.
When clients have a high level of experiential avoidance, we bring in an

ACT process with the odd-sounding name of ‘creative hopelessness’.
(Note: that’s a textbook term only; we’d never use it with clients.)
Creative hopelessness is a gentle, validating and extremely

compassionate process for undermining experiential avoidance. It gets
its odd name because it creates a sense of hopelessness about your
ongoing attempts to avoid/escape/get rid of unwanted emotions – and
this then paves the way for experimenting with a new and radically
different approach: mindfulness and acceptance.
If you have forgotten or are not

sure about what this process
involves, check out my
free eBook: The Nuts & Bolts
of Creative Hopelessness.

What’s the Point of ‘Tuning In’
to Your Emotions?
For many people, the idea of tuning in to feelings in their body is a bit
odd – or even downright weird! So all such work needs to be clearly
and explicitly linked to the client’s therapy goals: how will developing
this ability help them to be the person they want to be, do the things
they want to do, build the sort of life they want to lead?
If our clients don’t have a good rationale for how a greater connection
with their emotions (and/or a greater ability to label them) is going to
be of benefit, we can expect confusion and resistance.
So we need to be crystal clear with the client on:
a) How physical feelings/sensations are a big component of any

emotion; and when disconnected from that component, they’re
missing out on a large part of their emotional experience.
b) How having full access to their emotions can help them with
their therapy goals, make it easier for them to do things they
want to do.
I can’t overstate the importance of these points.
This is one of the most common issues I’ve encountered in

supervision: all too often, a therapist will ask a client to tune into their
body, tune into their feelings, without making it explicit and clear as to
how this will help the client overcome their problems or achieve their
therapy goals.

Here’s a metaphor I’ve found very useful for quick and
simple psychoeducation …
The ‘Kids In The Classroom’ Metaphor

Remember when you were a kid and your teacher left the classroom?
What happened? All hell broke loose, right?
Well, it’s the same thing with our emotions.
Our awareness is like the teacher, and our emotions are like the kids. If
we’re not aware of our feelings, they act up, create havoc, run wild. The
less aware we are of our feelings, the more they control our actions;
they jerk us around like a puppet on a string and easily pull us in to
problematic patterns of behavior.
When the teacher returns to the classroom, the kids immediately

settle down. Same deal when we bring awareness to our feelings; they
lose their impact and their ability to jerk us around. They’re still there,
but they don’t control us.

Common Benefits
of Better Access to Emotions
With each unique client, we want to clarify how better access to their
emotions can help them with their unique therapy goals. This extract
from my book, The Happiness Trap (2nd edition), summarises the
most common benefits:
• Vitality
You may gain a sense of vitality, of ‘coming back to life’, ‘feeling
fully human’.
• Joy and pleasure

Cutting off from your body helps you to avoid painful feelings —
but also cuts you off from pleasurable emotions and feelings, like
joy and happiness. So, connecting with your body gives you access
to the full range of emotions and feelings — both painful (e.g.
sadness, anger and anxiety) and pleasant (e.g. love, contentment
and joy).
• Control over your actions

The less aware you are of your emotions, the less control you have
over your actions. When we bring awareness to our feelings, they
lose much of their ability to hook us and jerk us around.
• Wise choices and good decisions

A wealth of research shows that the better we can access our
emotions, the more effective our decision making, and the more
likely we are to make wise choices in life.

• Intuition, trust and safety
Feelings in our body often alert us to threats and dangers that
our conscious mind is not picking up. Without access to this
information — often called ‘intuition’ or ‘gut feelings’ — we may
unwittingly put ourselves at risk or allow ourselves to be taken
advantage of.
• Safety in your own body

Do you feel unsafe in your own body? If you wish to feel safer in
your body, your best option is to start progressively exploring it,
and practise better ways to handle the difficult feelings you’ll
encounter. If you don’t do this work, your body will remain like a
dark cave full of monsters that you want to avoid at all costs.
• Success in life
There is a direct correlation between success in life and what
psychologists call ‘emotional intelligence’: handling your emotions
effectively and making good use of them to enhance your life.
Learning to tune into your body and access your emotions plays a
big part in increasing emotional intelligence.
• Building better relationships

One of the most important factors in building a meaningful and
rewarding life is the cultivation of strong, healthy relationships.
And no matter who those relationships are with — a partner,
friends, children, family, work colleagues or members of our
community — we will be at a huge disadvantage if we don’t have
ready access to our full range of emotions. Why? Building good
relationships requires emotional intelligence, not just in terms of
handling our own feelings, but also being able to tune into and
handle the feelings of others.

To understand how emotional intelligence helps build better
relationships, consider this:
Have you ever watched part of a movie on TV without any sound?

It’s not very satisfying. The images may be great, but without music,
dialogue or sound effects, you lose a lot of the experience. If you watch
carefully, you can still keep track of what’s happening to some
extent, but it’s easy to misread what’s going on.
And that’s what it’s like when we interact with others while we’re cut
off from our own feelings. It leads to conflict, tension and difficult
interactions with others, because we easily misread what they want
or don’t want — their intentions, their feelings — or we fail to see how
our own behaviour is affecting them.

Working ‘Bottom Up’
Depending on the client and their issue, an ACT session may take
either a ‘bottom up’ or a ‘top down’ approach.
A ‘bottom up’ approach means working primarily with the body:

feelings, sensations, somatic awareness, autonomic arousal, physical
movement, physical posture, the sensory components of emotions,
and so on.
A ‘top-down’ approach means working primarily at a cognitive level:

psychoeducation, noticing thoughts and thought patterns, cognitive
defusion, flexible perspective taking, working with metaphors,
clarifying values, setting goals, action-planning, problem solving,
exploring how past history has influenced current patterns of
behaviour, and so on.

Most ACT sessions include both ‘top down’ and ‘bottom up’
interventions; the proportion of each varies from session to session,
flexibly tailored to the needs of each unique client.
When disconnection from feelings is an issue, a ‘bottom up’ approach

is essential. In other words, we do lots of ‘mindful bodywork’:
somatic awareness, interoceptive exposure, mindfulness of posture,
mindfulness of movement, progressive muscle mindfulness, mindful
body scans, careful graded exposure to avoided parts of the body (or
avoided feelings within the body), and so on.
While all forms of ACT include ‘body work’, it arguably gets the
greatest emphasis in Trauma-Focused ACT. If you’re not yet familiar
with this model, you may like to read the first chapter of Trauma-
Focused ACT. Over time, bodywork helps the client to both tune into
and accept their feelings. These kinds of exercises are ideally practiced
first in session, under the therapist’s guidance, and then practiced
regularly outside of it.

Graded Exposure To
Difficult Feelings
It can be challenging to keep bodywork safe, because often clients
are striving hard to avoid particular parts of the body, especially
the chest and abdomen (because this is where anxiety sensations
are often most intense), areas associated with a trauma history
(e.g., parts involved in sexual abuse), and areas that are the focus of
intense dislike or loathing (as may occur in gender dysphoria or body
dysmorphic disorders).
In such cases, we can initially help clients connect mindfully with ‘safe
zones’ of the body—areas unlikely to trigger problematic reactions
(for example, the hands and feet are safe zones for most people.) Then
over time, through a process of graded exposure,
we can help them tune in to avoided areas.

Recognising & Labelling
Emotions
Some clients find it difficult or impossible to recognise and label their
emotions. Typically, if you ask them what they are feeling, you’ll get
vague answers like ‘I don’t know’, ‘good’, ‘bad’, ‘okay’.
Technically this is called ‘alexithymia’ - a fancy Greek term meaning

‘no words for emotions’. Alexithymia is a skill-deficit that usually
occurs because someone grows up in an environment where no one
teaches them how to recognise and label their emotions.
In such cases, we work on building emotional literacy: teaching

clients to distinguish and label different emotions, much as we
would a young child.
lo u s y
jea
resen
tment
anger
frustr
ation
When we see evidence that the client is feeling something
(e.g., they look or sound angry, sad, anxious, guilty, happy), we ask
them to tune into their body and notice: Where are they feeling it,
and what’s it like? What urges or impulses go with it, or ‘What does it
make you feel like you want to do’?
We can then help them to label the emotion: ‘You feel like crying
and curling up into a ball? Tears in your eyes? Heavy chest? That
is sadness’; ‘You feel like yelling, hitting, smashing things? Fists
clenched? Jaws tight? Heart pounding? That’s anger.’ And so on.
We may start with the ‘basic five’—sad, mad, glad, scared, relaxed
(sadness, anger, joy, happiness, relaxation)—and then gradually
expand the repertoire.
Alexithymia often – but not always - goes hand-in-hand with

disconnection from feelings in the body. So in addition to helping
clients learn to name their emotions, we usually have to help them
learn how to tune in to their body.

What’s the Point of
Naming Emotions?
If a client asks you, ‘What’s the point? How will this help me?’,
do you have a good answer? It’s important that clients understand
the point of learning to recognise and name what they are feeling.
(Again, without such understanding, we can expect confusion
and resistance.)
So you may like to come up with your own version of this spiel:
When we put what we are feeling into words, this activates part
of the ‘prefrontal cortex’ (that portion of our brain directly behind
our forehead).
This has a moderating effect on other parts of the brain that are
stirring up our emotions - an effect often described as ‘damping
down’ or ‘putting the brake on’ emotions.
In other words, when we notice and name our emotions, they lose
much of their ability to jerk us around. They’re still there, but they
have less impact; they lose a lot of their power; we are no longer
compelled to OBEY them or STRUGGLE with them.
A wealth of scientific research shows the less your ability to name

your emotions, the more likely they are to hook you and jerk you
into self-defeating patterns of behaviour. So it’s well worth making
the effort to develop this important psychological skill.

Regular ‘Check-ins’
It’s often useful to introduce clients to the idea of a regular ‘check in’.
Basically, throughout the day, you ‘check in’ to your body: ask yourself,
‘What am I feeling?’ or ‘What feelings am I having?’ (keep in mind,
often there’s more than one).
To help with this, it’s often good to keep a written record, in a journal,
diary, word document, or a smart phone app such as ‘Emotionary’.
It’s also good to have a list of emotions that can be looked at regularly,
such as this one. Ideally a client prints this out or keeps it readily
accessible on their phone or computer; that way they can use it
whenever they want some help to figure out what they’re feeling.

The ‘Basic Five’: Sad,
Angry, Happy, Afraid, Relaxed
It’s good to start off learning to name just a small number of ‘basic’
emotions. I usually suggest these five to begin with: sadness, anger,
happiness, fear and relaxation. (Or, if you prefer the easy-to-remember
list: sad, mad, glad, scared, relaxed.)
1 Happiness
A pleasurable emotion, that comes with a sense of being
energised. Other words that come under the same umbrella:
pleased, glad, excited. Other words that come under the same
umbrella: for extreme happiness - delighted, joyful, ecstatic; for
milder happiness: cheery, content.
2 Relaxation
A pleasurable emotion, that comes with a sense of slowing down,
winding down, as well as a sense of being safe and secure. Other
words that come under the same umbrella: calm, peaceful.

3 Anger
An unpleasant emotion that energises, activates, stirs us up;
comes with an urge or tendency to want to stand our ground
or fight. Other words that come under the same umbrella: for
extreme anger - enraged, furious; for milder anger - annoyed,
irritated. If you’re feeling wired up, tensed up, ready for fight or
conflict, like you want to yell or shout or smash things or lash
out - then you’re probably feeling some form of anger.
4 Fear
An unpleasant emotion that energises, activates, stirs us up;
comes with an urge or tendency to want to take evasive action,
protect ourselves against danger. Other words that come
under the same umbrella: for extreme fear - dread, horror;
for milder fear - nervous, anxious, worried. If you’re feeling
tensed up, ready to escape or avoid something, or a sense of
needing to protect yourself or others from danger - then you’re
probably feeling some form of fear.
5 Sadness
An unpleasant emotion that comes with a sense of slowing
down and a sense of loss or missing out. Other words that
come under the same umbrella: unhappy, miserable. For
extreme sadness: heartbroken, devastated; for mild sadness:
disappointed, gloomy. If you feel a sense of wanting to slow
down, rest up, cry, hide away from the world, along with a
sense of losing or missing out on something important, you’re
probably feeling some form of sadness.

A Quick Recap
• Pleasant, energising - Happiness
• Pleasant, slowing down, safe and secure - Relaxation
• Unpleasant, energising, urge to fight or stand your ground - Anger
• Unpleasant, energising, urge to hide, avoid, escape - Fear
• Unpleasant, slowing down, sense of loss or missing out - Sadness
Checking In & Naming

Emotions
After we’ve covered the above, we can I’m noticing
now invite clients to do something like sadness
this, outside of session:
Check in on yourself throughout the

day and see if your feeling fits into one
of those basic five emotions. It doesn’t
have to be a perfect fit; near enough is
good enough for now, because this is
a skill you’ll improve over time. If you’re
clear on what you’re feeling, name it:
“I’m noticing happiness” or “Here’s a
feeling of sadness”. But if you’re not
clear, ask yourself, “Which of these
basic emotions is it most like?”

Going Further
Once someone has the hang of naming those basic five emotions,
they can go further, as follows:
a) Learn to name different degrees or intensities of those

emotions, as in the examples above (e.g. extreme anger =
enraged, furious; mild anger = annoyed, irritated).
b) Learn to recognise and name other common emotions such

as guilt, shame, disgust, surprise and love.
This work obviously continues

during every session. When it
appears to us that the client is
having an emotional reaction, we
ask them to pause for a moment,
‘check in’, notice what they’re
feeling in their body, and see if they
can give a name to their emotion.
And for ongoing practice outside

the session, we may suggest that
once a week (or once every few
weeks) your client looks through
the emotion list provided earlier
(or a similar one) and picks a new
emotion to work with. (If they aren’t
sure what the emotion is, they can
ask you or Google it.) They then
practice noticing and naming this
‘new’ emotion when it occurs.

What About Emotional
Numbness?
When clients are emotionally numb – that is, they describe
themselves as feeling numb, empty, hollow, nothing, ‘dead inside’, or
‘like a zombie’ – this almost always relates to trauma, and ‘emergency
shutdown mode’.
In these cases, it’s important to provide basic psychoeducation,

about how when we experience intense pain — physical, emotional
or psychological — our vagus nerve literally numbs us: it actually
‘cuts off’ our feelings to spare us from the pain. And following severe
or repeated trauma, this automatic, involuntary, ‘numbing of our
pain’ persists.

Also keep in mind, when first doing ‘body work’ with numb clients,
they may find it hard to notice anything other than the most vague,
diffuse, and hard-to-locate feelings.
If so, we may initially help them create ‘safe sensations’ (i.e. unlikely to
trigger negative reactions) that they can more easily tune into – e.g.
through stretching, or moving, or contracting and releasing muscles,
or self-massage of a particular area.
In such cases, everything we covered in the pages above will come in

useful at various stages in therapy. However, we’ll obviously need to
deal with all the other aspects of the trauma. Trauma-Focused ACT is
the ideal approach for these kinds of issues. I mentioned the textbook
earlier; there’s also an online course of the same name, which you can
find on the final page of this eBook (along with six other courses).
Wrapping Up
Well, obviously there’s soooooo much more on this topic, but here’s
hoping you’ve got at least a few practical tips. And please feel free to
share this eBook - or the documents linked within it - with anyone you
think will benefit.
Good luck with it all.
Cheers,
Russ Harris

About Russ
Dr. Russ Harris is an internationally
best selling author, medical doctor,
psychotherapist, life coach, and consultant
to the World Health Organisation.
He has directly trained over 80,000 psychological health professionals

in the ACT model (in Australia, Europe, UK and USA), and his textbook
for professionals, ACT Made Simple, has sold over 150,000 copies. Of
the nine books he has written, the best known is The Happiness Trap,
which has sold over one million copies, and been translated into thirty
languages. Check out some of Russ’s ACT videos below:
The Choice Point: The Happiness Trap:

A Map for a Meaningful Life Evolution of the Human Mind
The Struggle Switch Sushi Train Metaphor

Online Training in ACT
For online training in ACT, you might like to check out Russ’s courses:
ACT for Beginners

Mental Health Professionals
16hrs | 6 weeks VIEW COURSE
ACT for Adolescents

ACT for Trauma

ACT for Depression and Anxiety

ACT as a Brief Intervention

ACT for Grief and Loss

EW
ACT for Perfectionism and People Pleasing

N


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ACT

When Clients Can’t Connect

6 What Causes Disconnection from Emotions?

7 Do Clients Have to Connect with Their Emotions?

8 When Clients Don’t Want to Connect with Emotions

9 What’s the Point of ‘Tuning In’ to Emotions?

10 The ‘Kids in the Classroom’ Metaphor

11 Common Benefits of Better Access to Emotions

14 Working ‘Bottom Up’

16 Graded Exposure to Difficult Feelings

17 Recognising & Labelling Emotions

19 What’s the Point of Naming Emotions?

21 The ‘Basic Five’: Sad, Angry, Happy, Afraid, Relaxed

24 Going Further with Noticing & Naming Emotions

25 What About Emotional Numbness?

28 Online Training in ACT

© Russ Harris, 2023 Psychwire.com/Harris 2

What’s the Difference Between

But most commonly – at least, in the world of coaching, counselling,

Speaking very simplistically, what we call an ‘emotion’ is a loose

© Russ Harris, 2023 Psychwire.com/Harris 3

However, it’s important to remember, all emotions include cognitions

The cognitive component of an emotion

b) The meaning we make of it

c) The images or memories that go with it

© Russ Harris, 2023 Psychwire.com/Harris 4

Unfortunately, confusion arises because the term ‘feeling’ is

For example, when exploring the emotion called ‘anxiety, we

© Russ Harris, 2023 Psychwire.com/Harris 5

This may be due to:

• Physical trauma or illness

• Medication-induced emotional blunting

• In addition to all the above, sometimes a person has simply never

© Russ Harris, 2023 Psychwire.com/Harris 6

Do Clients Have to Connect

However, if disconnection from feelings is a problem for the client

© Russ Harris, 2023 Psychwire.com/Harris 7

When clients have a high level of experiential avoidance, we bring in an

Creative hopelessness is a gentle, validating and extremely

If you have forgotten or are not

© Russ Harris, 2023 Psychwire.com/Harris 8

So we need to be crystal clear with the client on:

a) How physical feelings/sensations are a big component of any

I can’t overstate the importance of these points.

This is one of the most common issues I’ve encountered in

© Russ Harris, 2023 Psychwire.com/Harris 9

The ‘Kids In The Classroom’ Metaphor

Well, it’s the same thing with our emotions.

When the teacher returns to the classroom, the kids immediately

© Russ Harris, 2023 Psychwire.com/Harris 10

• Joy and pleasure

• Control over your actions

• Wise choices and good decisions

© Russ Harris, 2023 Psychwire.com/Harris 11

• Safety in your own body

• Building better relationships

© Russ Harris, 2023 Psychwire.com/Harris 12

Have you ever watched part of a movie on TV without any sound?

© Russ Harris, 2023 Psychwire.com/Harris 13

A ‘bottom up’ approach means working primarily with the body:

A ‘top-down’ approach means working primarily at a cognitive level:

© Russ Harris, 2023 Psychwire.com/Harris 14

When disconnection from feelings is an issue, a ‘bottom up’ approach