第三章：正念接纳

第三章

正念接纳

正念接纳是EET的第二个组成部分，源自正念冥想和基于正念的压力减少实践。它建立在情绪觉察技能（第二章）的基础上，并为练习情绪冲浪（第四章）做准备。正念接纳在情绪觉察的基础上增加了非评判性观察和接纳的意图。它还强调对情绪体验的视角转换，帮助来访将自己与情绪体验区分开来，从而在情境适应性和价值观一致的情况下创造空间和灵活性以应对痛苦。

EET技能目标：

观察 + 接纳情绪

关于正念接纳的心理教育

在EET中，我们使用正念接纳技能来促进一种非评判性的观察、灵活性和对当下体验的好奇心。正念接纳简单地将这种姿态与情绪觉察结合起来。通过接触当下，并学习观察和接受情绪的所有组成部分，来访可以开始有意识且有意地选择他们的反应。

通过练习正念接纳，来访还学会了他们不是他们的情绪。作为体验的观察者，他们自身是恒定不变的，而情绪则来去匆匆。类似于针对思维的解离练习（Hayes等人，1999），来访通过观察和接受情绪的所有组成部分（感觉、感受、想法和冲动）来从情绪中解离。他们学会可以观察并允许情绪体验而不与之混为一体。这种视角转换练习将为来访在被情绪触发时创造一个选择的空间（本章稍后会详细介绍），使他们可以选择如何回应。

正念接纳与人们本能地对困难情绪的反应方式截然不同，尤其是那些情绪问题困扰的人。人类天生倾向于通过避免体验这些情绪或对它们作出反应或行动来生存，以防御或转移不舒服的体验。通常，来访不会观察和接受被触发的体验，而是默认采取不适应的反应，这些反应虽然提供短期缓解，但最终无助于有效应对。

一些来访可能一开始也会在面对自己的痛苦时感到挣扎。体验痛苦而不逃避、不行动或试图控制它可能会感觉像是一个勇敢、新奇且令人恐惧的世界。来访可能已经非常擅长逃避情绪体验，以至于他们发现仅仅连接到当下的体验都很困难。不适感是可以预期的，特别是因为它要求我们去做与大脑进化所驱动的相反的事情：避免痛苦。正如任何新的行为一样，用正念接纳来应对困难情绪需要时间和练习，但对于情绪效能来说是必不可少的。

随着治疗的进展，帮助您的来访不断反思避免痛苦或试图改变情绪体验是如何让他们陷入情绪失调的恶性循环中是有益的。这种不适应的反应也阻止了来访以反映其价值观的方式出现，并创造他们想要的生活。我们将在第五章和第六章《基于价值观的行动（第一部分）》和《基于价值观的行动（第二部分）》中详细探讨这一点。

此外，强调正念接纳并不意味着对痛苦或其触发因素的认可或赞同，而是允许一个超出个人控制范围的体验。最终，练习正念接纳将使来访能够以真实且丰富生活的方式应对痛苦和困难情绪。

在开始正念接纳的会话之前，您需要与来访进行交流，了解他们对正念的了解程度，以便评估他们需要多少心理教育。以下是一些有助于不太熟悉正念的来访的“入门”视频。

短动画视频介绍正念

简短动画片段：正念简介
与正念专家Jon Kabat-Zinn的简要介绍：来自psychalive.org, 2013

以下是一份您可以用来介绍正念接纳的手册，以及一个引导来访进行正念接纳练习的脚本。

正念接纳 | 观察 + 接纳

正念接纳源自正念实践，已被多项研究证明可以减少心理压力并改善幸福感。正念接纳对于情绪效能至关重要，因为它可以帮助您更好地容忍困难的情绪、更快地恢复，并以丰富生活的方式做出反应。

正念接纳将帮助您练习观察和接受情绪，而不是对它们作出反应、逃避或试图控制。这并不意味着您必须“喜欢”您的情绪；它仅仅意味着您不抗拒正在经历的情绪。

一个有用的比喻是把自己想象成大气层，而情绪则是天气。大气层是恒定不变的，而天气则不断变化。在正念接纳中，您只是观察和接受变化中的天气，而不做出反应，同时作为观察者的您保持恒定不变。

当情绪被触发时，使用正念接纳有许多好处：

练习正念接纳可以帮助您忍受痛苦而不采取行动。
练习正念接纳可以帮助您更快地从触发的痛苦中恢复。
练习正念接纳可以帮助您找到所需的空间，有意识且审慎地选择如何应对痛苦。

正念接纳通过学习观察和接受情绪的四个部分来实践：感觉、感受、想法和冲动。以下是您可以在会话之外进行技能练习时使用的简单描述。尝试每天至少练习10分钟，无论是在休息时还是在情绪被触发时。

感觉接纳

扫描您的身体，意图观察和接受感觉，而不是对其作出反应。注意感觉的所有细节：大小、形状、温度、紧张感和移动。看看是否可以让感觉变得柔和，并为它腾出空间，而不试图改变它……只是允许它如其所是。

感受标记

尝试识别与情绪相关的感觉。给它命名，并允许它如其所是，不加评判。

思维观察

清空您的思维，然后等待并观察每个升起的想法；让想法过去，不要卷入其中。回到当下，等待下一个想法出现。当一个想法升起时，您可以在心中说：“这是一个想法”，然后让它过去。如果您发现自己难以让想法过去，您可以承认它是一个“粘性想法”，然后让它过去。

冲动注意

注意情绪是否伴随着做某事或不做某事的冲动。允许自己坐下来面对冲动，而不采取行动或评判。然后注意到不采取行动是什么样的体验。

您越是练习这些正念接纳技能，您的情绪效能肌肉就会越强大。观察和接受情绪而不是采取行动将会变得越来越容易。

练习正念接纳还将为您准备好在EET中学到的其他技能。

引导正念接纳的脚本

接下来的十分钟，我将引导您进行一次正念接纳练习。您将练习在当下观察和接受您的情绪体验。在中立状态下练习正念接纳将增强您的情绪效能肌肉，并使您在被触发时更容易使用这项技能。

首先，请舒适地坐着，闭上眼睛或放松视线，选择一个前方的焦点。

现在，花几分钟时间注意您身体中的任何感觉。扫描您的身体，直到找到一种感觉，并将注意力集中在上面。看看您是否可以让它如其所是，并对其产生好奇。注意它的大小和形状；它是否在移动或保持不变；是否有任何温度或紧张感。看看您是否可以让它变得柔和，甚至深入这种感觉……

接下来，看看您是否能识别与感觉相关的感受标签……只需命名它，并允许它如其所是，不加评判或反应。

然后，我们将花几分钟时间仅仅注意和观察我们的想法。我们的大脑一直在产生各种各样的想法，关键在于不要卷入其中。相反，每当一个想法升起时，您可以简单地说：“这是一个想法”，然后让这个想法过去。然后，回到当下，等待下一个想法出现。接下来的几分钟里，注意您的想法，直到我说停止……

好的，现在停止。接下来，看看是否有与您的感觉、感受或想法相关的冲动。它可能是做某事或不做某事的冲动。

尝试与冲动共处

试着与冲动共处。注意不去行动，只是冲浪般地体验这种冲动。 [让来访与冲动共处30秒。然后重复这个过程一次。] 在结束这项练习之前，请深呼吸几次，并慢慢睁开眼睛，将注意力带回房间。

在EET中使用暴露疗法

研究表明，在激活状态下进行演练可以改善学习、记忆和回忆（Szymanski & O’Donahue, 1995）。治疗往往包括关于如何做的知识，但缺乏帮助来访编码新行为的实践。许多情绪调节困难的来访既缺乏应对痛苦的知识，也缺乏使用技能的实践。通过基于暴露的技能练习，来访可以在会话之外被触发时创建所需的新神经通路。

在EET中，我们使用两种类型的暴露作为来访访问困难情绪并在激活状态下练习技能的方式。第一种类型是情绪暴露，涉及在激活状态下暴露于情绪的所有部分。第二种类型是想象暴露，涉及想象一个场景，暴露于该场景的情绪，并在激活状态下可视化对痛苦情境的行为反应。

您需要通过心理教育来准备来访进行暴露练习，包括解释其工作原理以及如何有效地参与练习。对于那些痛苦耐受力低且可能对身体感觉特别敏感的来访（如恐慌障碍患者），暴露可能会特别困难。重要的是要回顾选择暴露刺激物的指南，以确保提供足够的激活效果，但不至于使来访完全失调而无法参与练习。

以下的手册将帮助您向来访提供关于如何进行基于暴露的技能练习的指导和心理教育。

暴露介绍

在本次治疗中，我们将进行一些称为“暴露练习”的技能练习。这些练习旨在帮助您“暴露”于困难情绪的体验中，以便您可以学会从痛苦中恢复，并学习丰富生活的新应对方式。研究表明，当您面对痛苦而不是逃避时，不仅可以增加对痛苦的耐受性，还可以更快地恢复。

以下是其工作原理。首先选择一个让您感到痛苦的情境或场景。例如，尝试回忆上一次您生气的时候，并看看当您想到它时是否能感受到自己的激活状态。然后，使用以下SUDS工具评估它是否足够激活以用于您的暴露练习。

SUDS评分

SUDS评分代表主观痛苦单位量表。简单来说，这只是指您在想到某种情况时所经历的痛苦程度，从1到10的等级，1表示没有痛苦，10表示您能想象到的最大痛苦。对于每个情境，您需要预测如果您完全暴露于该情境的情绪中，您可能会有多难过。理想情况下，您的痛苦应在5到7之间。如果痛苦太低，练习可能无效；如果太高，您可能会分心，无法保持参与。

1 = 没有痛苦
3 = 明显的痛苦
5 = 中等痛苦
7 = 痛苦且不舒服
10 = 可以想象到的最严重的痛苦

如果在暴露练习中的任何时候，您开始感到过于痛苦以至于无法继续，您应该告诉治疗师和/或停止练习。您是主导者。

治疗师-来访对话示例：引入正念接纳与情绪暴露

治疗师：让我们尝试一个结合正念接纳技巧的练习。花几分钟时间思考最近让您感到痛苦的一个情境。您想选择一个您预计会在SUDS量表上达到5到7分的情境，其中1表示没有痛苦，10表示您可以想象到的最严重的痛苦。

来访：[暂停] 好的，比如我男朋友总是迟到接我，而且不打电话。

治疗师-来访对话示例：引入正念接纳与情绪暴露

治疗师：好的。你预测那个场景会让你有多痛苦？

来访：哦，那让我很生气。大概有6.5分吧。

治疗师：好的，很好。我们花几分钟时间进入那个场景。闭上眼睛，我会引导你。

来访：好的 [闭上眼睛]。

治疗师：想象一下上次你在等他来接你的情景。把自己放在当时的物理位置中。回忆你周围能看到的、能听到的东西。你能看到自己在那里，并感受到那种情绪吗？

来访：哦，是的。我感觉到了。

治疗师：好的。你身体的哪个部位感受到了这种情绪？

来访：哇，我之前没有想过这个问题，但我的肩膀变得非常紧绷，而且我开始感到温暖，即使只是坐在这里回想。

治疗师：好的，很好。那么让我们探索一下完全接受这些情绪体验会是什么样子，从你感受到的紧绷和温暖开始。你能允许这些感觉存在而不去评判它们，不去对它们做出反应，而是开放并放松地对待它们吗？

来访：好的 [深呼吸]。

治疗师：有没有一种感受伴随着这种感觉？

来访：我很生气。不……我是害怕。我想我害怕他其实并不爱我。如果他真的爱我，他会更兴奋地见我——他会准时。或者至少礼貌地打电话告诉我他晚了。

治疗师：所以你害怕他其实并不爱你。

来访：是的。我知道这听起来很夸张，但这就是我现在的想法。

治疗师：好的，很好。让我们练习观察你的想法并让它们过去几分钟。

来访：好的。就是告诉你吗？

治疗师：是的。你可以简单地说，“我有这个想法，他其实并不爱我”，然后让这个想法过去，等待下一个想法出现。

来访：好的。我有这个想法，“我不够漂亮。”

治疗师：好的，现在让这个想法过去，等待下一个。

来访：好的……我有这个想法“我反应过度了”，现在我让它过去。

治疗师：很好。

来访：[暂停] 我有这个想法“他不需要我像我需要他那样多”。这个很难放下 [叹气]。

治疗师：没关系。你可以承认它，说“这是一个粘性的想法”，然后让它过去。

来访：好的。

治疗师：你能识别出伴随这些想法的冲动吗？

来访：嗯，肯定有想摇晃他并责备他的冲动！

治疗师：好的。你能试着通过观察和接受这种冲动来与它共处吗？看看是否可以允许它如其所是？也许你可以想象为这种冲动腾出空间而不采取行动。

来访：我会试试。

治疗师：[暂停十五秒] 现在你的身体里发生了什么？

来访：它有点放松了……我的思维也没有那么快了。

治疗师：所以你感觉到的紧张已经放松了吗？

来访：是的。还有一点点，但少了很多。

治疗师：好的。你的思维也在放慢吗？

来访：是的。我仍然有这个想法“他其实并不爱我”……但是……一旦我的身体放松了，它就不再那么“粘性”了。好像它们是相互关联的。

治疗师：没错。那么让我们再停留一会儿在这个想法上。看看你能否只是承认这个想法，而不去反应，不去评判，而是让它过去。

来访：好的。

治疗师：现在发生了什么？

来访：我有这个想法“这真的很不同。”

治疗师：你是说放下你的想法？

来访：是的。我没有意识到我有选择。也许当这种情况实际发生时，我可以这样做。

治疗师：这就是目标。那么你现在SUDS水平是多少？

来访：嗯……我认为大约是2或3。

治疗师：好的，很好。让我们结束这次练习。深吸一口气，慢慢呼出，同时睁开眼睛回到房间。

选择的时刻

一旦来访理解了如何练习正念接纳，您就需要解释如何找到选择的时刻。找到选择的时刻对于情绪效能非常重要，因为这使来访能够找到空间，以有效且可能丰富生活的方式应对困难情绪。

选择的时刻是来访将选择使用EET技能的时候：情绪冲浪（第4章）、基于价值观的行动（第5章）、放松和自我安抚（第7章）、应对思维（第8章）以及分散注意力和暂停（第9章）。您需要强调找到并利用这个“时刻”对于提高情绪效能至关重要。

以下是一份您可以与来访分享的手册，用于介绍选择的时刻。（单页版本请访问 http://www.newharbinger.com/34039，或参见附录C。）

选择的时刻

作为人类，我们无法控制是否会有情绪。情绪会自然地在我们内部和周围发生的事情中产生。但我们能控制我们对情绪的反应，而这正是我们发现真正的情绪效能的地方。

神经学家兼精神科医生维克多·弗兰克尔对此概念进行了如下阐述：刺激与反应之间存在一个空间。在这个空间里，我们有自由和力量来选择我们的反应。在这些选择中，我们找到了成长和幸福。（无日期）

我们如何有效地应对困难情绪取决于能否找到这个“选择的时刻”。这一时刻是你意识到自己被情绪触发，并意识到你有能力选择如何回应的时候。你可以将其视为一种“神圣的停顿”，在这时你可以选择反应、逃避或试图控制它——或者你可以选择一种丰富生活的回应方式。

在EET中，你将学习多种技能，可以在选择的时刻使用这些技能，帮助你以一种接近你当下想要创造的东西的方式来应对你的情绪。

EET模型 = 观察 + 接纳情绪 > 找到选择的时刻 > 选择EET技能

治疗师-来访对话示例：与来访讨论找到选择的时刻

治疗师：现在你知道如何观察和接受情绪的各个组成部分了，你准备好练习找到选择的时刻了。

来访：那是什么？

治疗师：选择的时刻是你在面对痛苦时认识到自己有选择权的那一刻。这是你认识到可以选择一种有意识且真实反应的时刻，而不是让情绪主导一切。

来访：但如果我找不到呢？如果我在练习正念接纳后仍然非常生气，还是按照情绪行事怎么办？

治疗师：找到选择的时刻需要练习，但随着你不断尝试，它会变得越来越容易。找到它的关键是暂停足够长的时间，意识到你在如何回应上有选择权。这有道理吗？

来访：我想是的。

治疗师：我们来试试吧。我们现在试着用一个触发情境来找到选择的时刻。你能想到最近发生的一个触发情境吗？

来访：当然。上周我的一个同事把我的想法据为己有了。

治疗师：触发点是什么，或者你意识到这件事发生的那一刻是什么时候？

来访：她在一次全公司范围的市场会议上宣布那是她自己的想法。

治疗师：好的，我们就用这个例子。闭上眼睛，我们花几分钟时间进入那个场景。把自己定位在会议中，回忆她说的话，让自己情绪激活起来。

来访：[闭着眼睛] 哦，我被激活了！

治疗师：很好。当你想到她把你的想法据为己有的那一刻，你有什么感觉？

来访：我想伸手过去掐死她！她知道我为了升职付出了多少努力。

治疗师：那你做了什么？

来访：我站起来离开了会议。

治疗师：好的，让我们处理这种情绪。让我们从你身体的感觉开始，使用正念接纳。

来访-治疗师对话示例：找到选择的时刻

来访：是的……我的心跳加速了……嗯……我的胃很紧张，非常紧张。几乎就像被重击了一样。

治疗师：好的，让我们暂时停留在这种紧张的感觉上。注意这种紧张的大小和形状，并看看你是否可以允许它如其所是。

来访：好的。是的。它的大小和形状像一个柚子……

治疗师：很好，现在注意一下它是否有温度……是热的、冷的还是中性的。

来访：它是温暖的。

治疗师：现在，注意当你接受这种感觉并为它腾出空间时会发生什么……它改变了吗？还是保持不变？

来访：它放松了一点。

治疗师：好的，很好。现在试着识别与这种感觉以及掐死同事的冲动相关的情感标签。

来访：就是……愤怒。纯粹而简单。

治疗师：好的，很好。现在试着对这种愤怒的感觉软化……为它腾出空间，只是允许它如其所是。

来访：它很强烈，但好吧。我会试试。

治疗师：好的，就让它强烈地存在吧。继续尝试软化它，甚至向它靠拢。

治疗师：[暂停30秒] 现在这种感觉怎么样了？

来访：它开始感觉有点无聊。

治疗师：无聊？

来访：是的，就像我厌倦了专注于它……而且它不再那么强烈了。

治疗师：好的，让我们进入观察思维的过程。

来访：我在想“她背叛了我，我不应该信任她。我真是太蠢了！”

治疗师：好的。你能承认她背叛了你的想法并让它过去吗？

来访：我不想让它过去，但我还是会试试。

治疗师：这是有道理的……你的大脑认为你需要抓住这个想法以避免再次受伤。但是看看你是否能承认这是一个粘性的想法，并让它过去。你总可以在其他时间再回来处理它。

来访：好的。现在我在想“我的情绪一团糟。”

治疗师：好的。你能看到这是一个评判性的想法，并且只是承认它并让它过去吗？

来访：好的……这是一个评判性的想法……再见！

治疗师：[轻笑] 你做得很好。现在让我们检查一下伴随这种情绪的冲动是什么。

来访：嗯。我还是想掐死她，但没那么强烈了。

治疗师：好的，所以你能注意到想要掐死她的冲动是什么样的吗？你能和它共处一会儿吗？

来访：好的。

治疗师：[等待30秒] 现在出现了什么？

来访：嗯，我感觉不太想掐死她了……这真是一个暴力的冲动。我有点尴尬。

治疗师：我理解。你能不带评判地允许这种感觉存在吗？

来访：是的，好的。

治疗师：停留在冲动中，看看你是否能想象不去行动，只是与它共处？

来访：是的……你是说不要离开会议？

治疗师：正是如此。只是观察并接受你有离开的冲动。

来访：好的。

治疗师：现在，你能找到你当时有选择权的那个时刻吗？

来访：嗯，如果我当时做了这些正念练习，我可能就在那一刻有了选择。

治疗师：没错，你能看到那个时刻吗？

来访：我想是的……如果在我生气的时候我能停下来并注意到选择的时刻，我本可以选择留在会议上？

治疗师：没错。通过使用正念接纳，你可能会看到自己在选择的时刻中的力量。

来访：是的，我能看到这一点。

治疗师：好的，深呼吸，慢慢呼出，同时睁开眼睛回到房间。在我们的下一次会话中，我们将学习一种新的正念接纳技能，叫做情绪冲浪，你可以用它来驾驭情绪，而不是采取行动。

本章知识点阐述

知识点阐述

正念接纳
- 定义：正念接纳是一种结合了非评判性观察和接纳的态度，以及对情绪体验的全面觉察。
- 重要性：
  - 帮助个体区分自我与情绪体验，从而更好地管理情绪。
  - 通过非评判性观察，减少对情绪的过度反应，提高情绪调节能力。
- 具体实践：
  - 非评判性观察：学习以非评判的态度观察情绪的所有组成部分。
  - 接纳情绪：接受情绪的存在，而不是试图改变或逃避。
  - 视角转换：将自己视为情绪的观察者，而不是情绪的一部分。
情绪觉察与正念接纳的关系
- 定义：情绪觉察是识别和理解情绪体验的能力，而正念接纳是在此基础上加入非评判性观察和接纳的态度。
- 重要性：
  - 情绪觉察是基础，帮助个体识别情绪；正念接纳进一步增强了情绪管理能力。
  - 通过结合两者，个体可以更灵活地应对情绪，减少情绪带来的负面影响。
- 具体实践：
  - 结合练习：在情绪觉察的基础上，加入正念接纳的练习。
  - 持续练习：通过持续练习，增强情绪觉察和正念接纳的能力。
正念接纳与情绪解离
- 定义：正念接纳通过观察和接受情绪的所有组成部分，帮助个体从情绪中解离，即认识到情绪是暂时的，而自我是恒定的。
- 重要性：
  - 减少情绪的压倒性影响，提高情绪调节能力。
  - 通过解离，个体可以更客观地看待情绪，从而做出更合理的反应。
- 具体实践：
  - 观察情绪：细致观察情绪的各个组成部分。
  - 接受情绪：接受情绪的存在，而不是试图改变或逃避。
  - 解离练习：通过练习，逐渐实现从情绪中的解离。
正念接纳与情绪调节
- 定义：正念接纳通过非评判性观察和接纳，帮助个体更好地调节情绪，减少情绪的负面影响。
- 重要性：
  - 提高情绪调节能力，减少情绪失调的情况。
  - 通过正念接纳，个体可以更灵活地应对情绪，避免不适应的反应。
- 具体实践：
  - 练习正念：定期进行正念练习，如正念冥想。
  - 应用技能：在实际情境中应用正念接纳技能。
  - 持续改进：通过持续练习，不断提高正念接纳的能力。
正念接纳与价值观一致性
- 定义：正念接纳帮助个体在情绪触发时保持冷静，从而能够做出符合价值观的选择。
- 重要性：
  - 通过正念接纳，个体可以在情绪激动时保持清晰的头脑，做出更符合价值观的决策。
  - 有助于个体在生活中更好地体现其价值观，创造更有意义的生活。
- 具体实践：
  - 明确价值观：确定个人的核心价值观。
  - 应用正念：在情绪触发时，运用正念接纳技能保持冷静。
  - 价值观一致性：确保情绪反应与个人价值观一致。

通过以上知识点的阐述，我们可以看到正念接纳不仅是一种重要的情绪管理技能，还能帮助个体更好地理解和应对情绪，提高生活质量。这些方法不仅提高了情绪调节的有效性，还提供了科学依据和实证支持，确保了治疗的可靠性和实用性。希望这些信息能为您提供有价值的见解，并在实践中有所帮助。

知识点阐述

正念接纳
- 定义：正念接纳是一种结合了非评判性观察和接纳的态度，以及对情绪体验的全面觉察。
- 重要性：
  - 帮助个体区分自我与情绪体验，从而更好地管理情绪。
  - 通过非评判性观察，减少对情绪的过度反应，提高情绪调节能力。
- 具体实践：
  - 非评判性观察：学习以非评判的态度观察情绪的所有组成部分。
  - 接纳情绪：接受情绪的存在，而不是试图改变或逃避。
  - 视角转换：将自己视为情绪的观察者，而不是情绪的一部分。
情绪觉察与正念接纳的关系
- 定义：情绪觉察是识别和理解情绪体验的能力，而正念接纳是在此基础上加入非评判性观察和接纳的态度。
- 重要性：
  - 情绪觉察是基础，帮助个体识别情绪；正念接纳进一步增强了情绪管理能力。
  - 通过结合两者，个体可以更灵活地应对情绪，减少情绪带来的负面影响。
- 具体实践：
  - 结合练习：在情绪觉察的基础上，加入正念接纳的练习。
  - 持续练习：通过持续练习，增强情绪觉察和正念接纳的能力。
正念接纳与情绪解离
- 定义：正念接纳通过观察和接受情绪的所有组成部分，帮助个体从情绪中解离，即认识到情绪是暂时的，而自我是恒定的。
- 重要性：
  - 减少情绪的压倒性影响，提高情绪调节能力。
  - 通过解离，个体可以更客观地看待情绪，从而做出更合理的反应。
- 具体实践：
  - 观察情绪：细致观察情绪的各个组成部分。
  - 接受情绪：接受情绪的存在，而不是试图改变或逃避。
  - 解离练习：通过练习，逐渐实现从情绪中的解离。
正念接纳与情绪调节
- 定义：正念接纳通过非评判性观察和接纳，帮助个体更好地调节情绪，减少情绪的负面影响。
- 重要性：
  - 提高情绪调节能力，减少情绪失调的情况。
  - 通过正念接纳，个体可以更灵活地应对情绪，避免不适应的反应。
- 具体实践：
  - 练习正念：定期进行正念练习，如正念冥想。
  - 应用技能：在实际情境中应用正念接纳技能。
  - 持续改进：通过持续练习，不断提高正念接纳的能力。
正念接纳与价值观一致性
- 定义：正念接纳帮助个体在情绪触发时保持冷静，从而能够做出符合价值观的选择。
- 重要性：
  - 通过正念接纳，个体可以在情绪激动时保持清晰的头脑，做出更符合价值观的决策。
  - 有助于个体在生活中更好地体现其价值观，创造更有意义的生活。
- 具体实践：
  - 明确价值观：确定个人的核心价值观。
  - 应用正念：在情绪触发时，运用正念接纳技能保持冷静。
  - 价值观一致性：确保情绪反应与个人价值观一致。

知识点阐述

暴露疗法的基本原理
- 定义：暴露疗法是一种心理治疗方法，通过让个体直接面对恐惧或痛苦的情境，以减少其对这些情境的过度反应。
- 重要性：
  - 帮助个体逐渐适应并克服恐惧或痛苦，从而提高其应对能力。
  - 通过实际体验，增强个体对情绪的容忍度和恢复能力。
- 具体实践：
  - 选择情境：选择一个能够引起适度痛苦的情境。
  - 逐步暴露：逐步暴露于该情境，直到个体能够更好地应对。
  - 持续练习：通过反复练习，巩固新的应对模式。
SUDS评分的作用
- 定义：SUDS（主观痛苦单位量表）是一种衡量个体在特定情境下所经历痛苦程度的工具。
- 重要性：
  - 帮助治疗师和来访量化痛苦的程度，从而选择合适的暴露情境。
  - 为暴露练习提供一个客观的参考标准，确保练习的有效性和安全性。
- 具体实践：
  - 评分范围：从1到10，1表示没有痛苦，10表示最严重的痛苦。
  - 选择适当的情境：选择一个在5到7之间的痛苦情境，以确保练习的有效性。
正念接纳与暴露疗法的结合
- 定义：正念接纳是一种非评判性的观察和接受态度，与暴露疗法结合可以帮助个体更好地应对痛苦情绪。
- 重要性：
  - 通过正念接纳，个体可以更客观地观察和接受情绪，而不被其压倒。
  - 结合暴露疗法，个体可以在实际情境中练习新的应对方式。
- 具体实践：
  - 观察情绪：在暴露情境中，细致观察情绪的各个组成部分。
  - 接受情绪：接受情绪的存在，而不是试图改变或逃避。
  - 解离练习：通过练习，逐渐实现从情绪中的解离，提高情绪调节能力。
暴露疗法的注意事项
- 定义：在进行暴露疗法时，需要注意选择合适的情境和控制痛苦的程度。
- 重要性：
  - 确保暴露练习的安全性和有效性。
  - 避免过度激活导致个体无法参与练习。
- 具体实践：
  - 选择适当的情境：选择一个能够引起适度痛苦的情境。
  - 监测痛苦程度：在练习过程中密切监测来访的痛苦程度。
  - 及时调整：如果痛苦程度过高，应及时调整或停止练习。

通过以上知识点的阐述，我们可以看到暴露疗法不仅是一种有效的心理治疗方法，还能通过与正念接纳相结合，进一步提高个体的情绪调节能力和生活质量。这些方法不仅提高了情绪管理的有效性，还提供了科学依据和实证支持，确保了治疗的可靠性和实用性。希望这些信息能为您提供有价值的见解，并在实践中有所帮助。

知识点阐述

情绪暴露与正念接纳的结合
- 定义：情绪暴露是一种心理治疗方法，通过让个体直接面对引发痛苦的情境，以减少其对这些情境的过度反应。正念接纳则是一种非评判性的观察和接受态度，与情绪暴露结合可以帮助个体更好地应对痛苦情绪。
- 重要性：
  - 通过正念接纳，个体可以更客观地观察和接受情绪，而不被其压倒。
  - 结合情绪暴露，个体可以在实际情境中练习新的应对方式，从而提高情绪调节能力。
- 具体实践：
  - 观察情绪：细致观察情绪的各个组成部分，包括身体感觉、情感、想法和冲动。
  - 接受情绪：接受情绪的存在，而不是试图改变或逃避。
  - 解离练习：通过练习，逐渐实现从情绪中的解离，提高情绪调节能力。
SUDS评分的应用
- 定义：SUDS（主观痛苦单位量表）是一种衡量个体在特定情境下所经历痛苦程度的工具。
- 重要性：
  - 帮助治疗师和来访量化痛苦的程度，从而选择合适的暴露情境。
  - 为暴露练习提供一个客观的参考标准，确保练习的有效性和安全性。
- 具体实践：
  - 评分范围：从1到10，1表示没有痛苦，10表示最严重的痛苦。
  - 选择适当的情境：选择一个在5到7之间的痛苦情境，以确保练习的有效性。
  - 监测痛苦程度：在练习过程中密切监测来访的痛苦程度，及时调整或停止练习。
观察和释放思想
- 定义：通过观察和释放思想，个体学会将自己与思想分离，认识到思想只是头脑中的活动，而不是事实。
- 重要性：
  - 减少对负面思想的过度认同，降低其对情绪的影响。
  - 通过练习，个体可以学会更灵活地应对思想，减少不必要的痛苦。
- 具体实践：
  - 观察思想：注意思想的出现，将其视为头脑中的活动。
  - 命名思想：给思想命名，例如“我有一个想法，他并不爱我”。
  - 释放思想：让思想过去，等待下一个思想出现，不对其做出反应。
识别和处理冲动
- 定义：识别和处理冲动是指在面对情绪触发时，识别出伴随的情绪冲动，并通过观察和接受的方式与其共处，而不是立即采取行动。
- 重要性：
  - 通过这种方式，个体可以避免因冲动行为带来的负面后果。
  - 提高情绪调节能力，使个体能够更冷静地应对情绪触发。
- 具体实践：
  - 识别冲动：注意到情绪触发时伴随的冲动。
  - 观察冲动：观察冲动的感觉，但不采取行动。
  - 接受冲动：接受冲动的存在，允许它如其所是，不加评判。

通过以上知识点的阐述，我们可以看到情绪暴露与正念接纳相结合不仅是一种有效的心理治疗方法，还能进一步提高个体的情绪调节能力和生活质量。这些方法不仅提高了情绪管理的有效性，还提供了科学依据和实证支持，确保了治疗的可靠性和实用性。希望这些信息能为您提供有价值的见解，并在实践中有所帮助。

知识点阐述

选择的时刻的重要性
- 定义：选择的时刻是指个体在情绪触发时，意识到自己有选择如何回应的权力和能力的瞬间。
- 重要性：
  - 通过找到选择的时刻，个体可以避免自动化的反应模式，从而更好地管理情绪。
  - 选择的时刻提供了机会，让个体能够采取更有效且符合价值观的行动。
- 具体实践：
  - 识别情绪：意识到情绪的存在及其影响。
  - 暂停：给自己一点时间，意识到自己有选择权。
  - 选择响应：根据当前的情境和目标，选择最合适的响应方式。
情绪效能的提升
- 定义：情绪效能是指个体有效管理和应对情绪的能力。
- 重要性：
  - 提高情绪效能有助于减少情绪失调，增强心理韧性。
  - 通过有效的情绪管理，个体可以更好地实现个人目标和价值观。
- 具体实践：
  - 学习技能：掌握多种情绪管理技能，如正念接纳、情绪冲浪、基于价值观的行动等。
  - 持续练习：通过反复练习，巩固新的应对模式。
  - 应用技能：在实际情境中应用所学技能，逐步提高情绪效能。
正念接纳与选择的时刻的关系
- 定义：正念接纳是一种非评判性的观察和接受态度，可以帮助个体更好地识别和管理情绪。
- 重要性：
  - 通过正念接纳，个体可以更客观地观察情绪，而不被其压倒。
  - 正念接纳为找到选择的时刻提供了基础，使个体能够在情绪触发时保持冷静，做出更有意识的选择。
- 具体实践：
  - 观察情绪：细致观察情绪的各个组成部分，包括身体感觉、情感、想法和冲动。
  - 接受情绪：接受情绪的存在，而不是试图改变或逃避。
  - 解离练习：通过练习，逐渐实现从情绪中的解离，提高情绪调节能力。
EET模型的应用
- 定义：EET（情绪效能训练）模型是一种综合的情绪管理方法，包括观察和接纳情绪、找到选择的时刻、选择合适的EET技能。
- 重要性：
  - EET模型提供了一种系统化的方法，帮助个体逐步提高情绪效能。
  - 通过结合多种技能，EET模型使个体能够更灵活地应对各种情绪挑战。
- 具体实践：
  - 观察和接纳情绪：通过正念接纳，观察和接受情绪的各个组成部分。
  - 找到选择的时刻：在情绪触发时，意识到自己有选择权。
  - 选择EET技能：根据具体情况，选择合适的EET技能进行应对。

通过以上知识点的阐述，我们可以看到选择的时刻不仅是个体情绪管理的关键节点，也是提高情绪效能的重要途径。这些方法不仅提高了情绪管理的有效性，还提供了科学依据和实证支持，确保了治疗的可靠性和实用性。希望这些信息能为您提供有价值的见解，并在实践中有所帮助。

知识点阐述

正念接纳的具体实践
- 定义：正念接纳是一种心理技术，通过观察和接受（而非逃避、反应或试图控制或改变）情绪体验的四个组成部分：感觉接纳、情感标记、思想观察和冲动觉察。
- 重要性：
  - 正念接纳帮助个体更客观地看待情绪，减少情绪的负面影响。
  - 通过接纳情绪，个体可以更好地管理情绪，提高情绪调节能力。
- 具体实践：
  - 感觉接纳：注意身体的感觉，如紧张、温暖等，并允许它们存在。
  - 情感标记：给情绪命名，例如“愤怒”、“悲伤”等。
  - 思想观察：观察自己的思维，尤其是那些评判性和粘性的想法，并让它们过去。
  - 冲动觉察：意识到伴随情绪的冲动，并学会不立即行动。
选择的时刻的重要性
- 定义：选择的时刻是指情绪触发和行动之间的空间，在这个空间里，个体可以有意识地选择如何回应。
- 重要性：
  - 通过找到选择的时刻，个体可以避免自动化的反应模式，从而更好地管理情绪。
  - 选择的时刻提供了机会，让个体能够采取更有效且符合价值观的行动。
- 具体实践：
  - 识别情绪：意识到情绪的存在及其影响。
  - 暂停：给自己一点时间，意识到自己有选择权。
  - 选择响应：根据当前的情境和目标，选择最合适的响应方式。
情绪暴露的作用
- 定义：情绪暴露是一种心理治疗方法，通过让个体直接面对引发痛苦的情境，以减少其对这些情境的过度反应。
- 重要性：
  - 通过情绪暴露，个体可以逐渐适应并克服恐惧或痛苦，从而提高应对能力。
  - 情绪暴露有助于个体发展更多的灵活性和适应性，以应对各种触发因素。
- 具体实践：
  - 逐步暴露：逐步暴露于困难情绪的情境中，直到个体能够更好地应对。
  - 持续练习：通过反复练习，巩固新的应对模式。
激活状态下的正念接纳
- 定义：在情绪被激活的状态下进行正念接纳练习。
- 重要性：
  - 在激活状态下进行正念接纳可以增强学习、记忆和回忆的效果。
  - 通过实际体验，个体可以更有效地将新的应对模式编码到行为中。
- 具体实践：
  - 情绪冲浪：学习如何在情绪波动中保持冷静，而不是采取行动。
  - 基于价值观的行动：根据个人的价值观选择行动，而不是受情绪驱动。

通过以上知识点的阐述，我们可以看到正念接纳不仅是个体情绪管理的重要工具，也是找到选择的时刻和提高情绪效能的关键。情绪暴露和在激活状态下进行正念接纳练习可以帮助个体更好地应对困难情绪，提高情绪调节能力和生活质量。希望这些信息能为您提供有价值的见解，并在实践中有所帮助。

Chapter 3 Mindful Acceptance Mindful acceptance is the second component of EET and is derived from the practice of mindfulness meditation and mindfulness-based stress reduction. It builds on the skill of emotion awareness (chapter 2) and prepares clients to practice emotion surfing (chapter 4). Mindful acceptance adds to emotion awareness an intention of nonjudgmental observation and acceptance. It also emphasizes perspective taking on emotional experience that helps clients distinguish themselves from their emotional experience, creating space and flexibility to respond to pain in a contextually adaptive, values-consistent manner. EET Skill Objective: Observe + Accept the emotion Psychoeducation on Mindful Acceptance In EET, we use the skill of mindful acceptance to facilitate a posture of nonjudgmental observation, flexibility, and curiosity about one’s experience in the present moment. Mindful acceptance is simply combining that posture with emotion awareness. By making contact with the present moment, and learning to observe and accept all components of emotion, clients can begin the practice of consciously and intentionally choosing their responses. By practicing mindful acceptance, clients also learn that they are not their emotions. They learn that, as the observer of their experience, they are constant while their emotions come and go. Similar to defusion exercises for thoughts (Hayes et al., 1999), clients learn to defuse from their emotions by observing and accepting all components of the emotion: sensations, feelings, thoughts, and urges. They learn that theycan watch and allow emotional experience without collapsing themselves with their emotions. This perspective-taking practice will create the space that allows clients to locate the moment of choice (covered later in this chapter) when they are emotionally triggered, and they can choose how to respond. Mindful acceptance is a radical departure from how people instinctually respond to difficult emotions, especially those who struggle with emotion problems. Humans are wired to survive difficult emotions by avoiding the experience of them, and/or reacting or acting on them to defend or shift the uncomfortable experience. Often, instead of observing and accepting the triggered experience, clients default to maladaptive responses that provide short-term relief, even though they do not ultimately help them effectively respond. Some clients may also struggle at first with exposing themselves to their pain. To experience pain without avoiding it, acting on it, or attempting to control it may feel like a brave, new, and terrifying world. Clients may have become so skilled in avoiding their emotional experience that they find it difficult just to connect to their experience of the present moment. Discomfort is to be expected, especially since it requires doing the opposite of what our brains are evolutionally wired to motivate us to do: avoid pain. As with any new behavior, responding to difficult emotions with mindful acceptance will take time and practice, but it is essential to emotion efficacy. As the treatment progresses, it will be beneficial to help your clients continually reflect on the ways in which avoiding pain, or trying to alter their emotional experience, keeps them trapped in a vicious cycle of emotion dysregulation. This maladaptive responding also prevents clients from showing up in a way that reflects their values and creating what they want. We will explore this in detail in chapters 5 and 6, Values- Based Action Part 1 and Values-Based Action Part 2. It may also be helpful to emphasize that mindful acceptance does not imply a condoning or approving of the pain or its trigger but rather an allowing of an experience outside of one’s control. And, ultimately, practicing mindfulacceptance is what will allow clients to respond to pain and difficult emotions in ways that are authentic and life enriching. Before you begin the session on mindful acceptance, you will want to check in with your clients to see what they may know about mindfulness, so you can gauge how much psychoeducation they may need. Below are a few “primer” videos on mindfulness that may be helpful to clients who are not familiar with mindfulness. Short animated clip on mindfulness: https://www.youtube.com/watch?v=5d46amlJEkI Brief introduction with mindfulness expert Jon Kabat- Zinn on mindfulness, taken from psychalive.org, 2013: https://www.youtube.com/watch?v=HmEo6RI4Wvs Following is a handout you can use to introduce mindful acceptance, along with a script for conducting mindful acceptance practice with clients. Mindful Acceptance | Observe + Accept Mindful acceptance is derived from the practice of mindfulness, which has been shown to reduce psychological stress and improve well- being in numerous studies. The practice of mindful acceptance is essential for emotion efficacy because it will help you better tolerate difficult emotions, recover more quickly, and respond in ways that enrich your life moment to moment. Mindful acceptance will help you practice observing and accepting emotions instead of reacting to them, avoiding them, or trying to control them. It doesn’t mean you have to “like” your emotions; it simply means that you don’t resist what you are experiencing. One helpful metaphor is to think of yourself as the atmosphere and your emotions as the weather. The atmosphere is constant, while the weather is ever-changing. In mindful acceptance, you simply observe and accept changing weather, without reacting, while you as the observer remain constant. There are many benefits to using mindful acceptance when you are emotionally triggered:• Practicing mindful acceptance can help you tolerate pain without acting on it. • Practicing mindful acceptance can help you recover more quickly from the distress of the trigger. • Practicing mindful acceptance can help you find the space you need to thoughtfully and consciously choose how you will respond to the pain. Mindful acceptance is practiced by learning to observe and accept the four parts of emotion: sensations, feelings, thoughts, and urges. Following is a simple description for practicing mindful acceptance you can use as you do your skills practice outside of session. Try to practice for at least 10 minutes a day when you are resting or when you get emotionally triggered. Sensation Acceptance Scan your body for sensations with the intention of observing and accepting them instead of reacting to them. Just notice all the details of the sensations: size, shape, temperature, tension, and movement. See if you can soften to the sensation and make space for it, without trying to change it…just allowing it to be exactly as it is. Feeling Labeling Try to identify the feeling that goes with the emotion. Name it and allow it to be exactly as it is, without judging it. Thought Watching Clear your mind, and then wait and watch for each thought as it arises; let the thought go without getting involved in it. Come back to the present moment and wait for the next thought to show up. When a thought arises, you might say to yourself, “There’s a thought,” and then just let it go. If you find yourself struggling to let the thought go, you might just acknowledge it as a “sticky thought” and then let it go. Urge Noticing Notice if the emotion comes with an urge to do or not do something. Allow yourself to sit with the urge, without acting on it or judging it. Then notice what it’s like not to act on it.The more you practice these mindful acceptance skills, the bigger your emotion efficacy muscle will grow. It will get easier and easier to observe and accept your emotions instead of acting on them. Practicing mindful acceptance will also prepare you to use the other skills you will learn in EET. Script for Guided Mindful Acceptance For the next ten minutes I’m going to lead you through a mindful acceptance practice exercise. You will practice observing and accepting your emotional experience in the present moment. Practicing mindful acceptance in a neutral state will build your emotion efficacy muscle and make it easier for you to use this skill when you are triggered. First, just sit comfortably, and either close your eyes or relax your gaze and pick a spot to focus on in front of you. Now, take a few minutes to notice any sensations in your body. Scan your body until you find a sensation and rest your attention on it. See if you can let it be just as it is and get curious about it. Notice its size and shape; whether it’s moving or staying the same; if there’s any temperature or tension to it. See if you can soften to it, or even lean into the sensation… Now, see if you can identify a feeling label that goes with the sensation…just name it and allow it to be as it is without judgment or reacting to it. Next, we’ll spend a few minutes just noticing and watching our thoughts. Our brains produce different kinds of thoughts all the time, and the key is not to get involved with them. Instead, as each thought arises, you can simply say, “There’s a thought,” and then let the thought go. Then, just return to the present moment, and wait for the next thought to arise. For the next few minutes, notice your thoughts until I say stop… Okay, now stop. Next, see if there’s an urge that goes with your sensations, feelings, or thoughts. Itcould be an urge to do something or not do something. Try to just sit with the urge. Notice what it’s like not to act on the urge, to just surf it. [Allow the client to sit with the urge for 30 seconds. Then repeat the sequence one more time.] Before you come out of this exercise, take a few deep breaths and slowly open your eyes as you bring your attention back to the room. Using Exposure in EET Research has shown that rehearsal in an activated state can improve learning, retention, and recall (Szymanski & O’Donahue, 1995). Too often treatment includes knowledge about what to do but not the practice that will help clients encode the new behavior. Many clients who struggle with emotion dysregulation lack both the knowledge and practice of using skills to respond to distress. By using exposure-based skills practice, clients are able to create the new neural pathways they need when they are triggered outside of session. In EET, we use two types of exposure as a way for clients to access difficult emotions and practice skills in an activated state. The first type, emotion exposure, involves exposing to all parts of emotion in an activated state. The second type, imaginal exposure, involves imagining a scenario, exposing to the emotion that goes with the scene, and, in an activated state, visualizing behavioral responses to the distressing situation. You’ll want to prepare your clients for exposure exercises by doing psychoeducation on how it works, as well as how to effectively engage in the exercise. Exposure can be especially difficult for clients who have low distress tolerance and who may also be especially sensitive to somatic sensations, as with panic disorder. It will be important to review guidelines for choosing an exposure stimulus that provides enough emotional activation to be effective but not so much that clients become completely dysregulated and can’t participate in the exercise.The following handout will help you provide guidance and psychoeducation to your clients about how to do exposure- based skills practice. Introduction to Exposure In this treatment we’ll be doing some skills practice we’ll call “exposure exercises.” The exercises are intended to help you “expose” yourself to the experience of difficult emotions so you can learn how to recover from distress as well as learn new ways of responding that enrich your life. Research shows that when you face distress instead of avoiding it, you can not only increase your tolerance of the distress but also recover more quickly. Here’s how it works. First pick a situation or scene that is distressing to you. For example, try to recall the last time you got upset, and see if you can feel yourself getting activated when you think about it. Then, assess whether it is activating enough to use for your exposure practice using the following SUDS tool. The SUDS Rating The SUDS rating stands for subjective units of distress scale. In plain terms, this just means how much distress you experience when you think about the situation on a scale of 1 to 10, with 1 being no distress and 10 being the most distress you can imagine. For each situation, you want to predict how upset you might become if you expose yourself fully to the emotion of the situation. Ideally, your distress will be in the 5 to 7 range. If your distress is too low, the exercise is unlikely to be effective, and if it’s too high, you may become distracted and unable to stay engaged. 1 = no distress 3 = noticeable distress 5 = moderate distress 7 = distressing and uncomfortable 10 = worst distress imaginable If at any point in the exposure exercise you begin to feel too distressed to stay with it, you should let the therapist know and/or stop the exercise. You are in the driver’s seat.Therapist-Client Dialogue Example: Introducing Mindful Acceptance with Emotion Exposure Therapist: Let’s try an exercise with mindful acceptance skills. Just take a few minutes to think of a recent situation that was distressing to you. You want to choose something you predict will be around a 5 to 7 on the SUDS scale, with 1 being no distress and 10 being the worst distress you can imagine. Client: [Pauses] Okay, like maybe when my boyfriend is always late to pick me up and doesn’t call. Therapist: Okay. How distressing do you predict that scene will be for you? Client: Oh, it gets me going. Probably like a 6.5. Therapist: Okay, good. Let’s take a few minutes to get into that scene. Just close your eyes and I’ll talk you through it. Client: Okay [closes eyes]. Therapist: Imagine the last time you were waiting for him to pick you up. Put yourself in the physical location you were in. Remember what you can see around you, what you can hear. Can you see yourself there, and are you feeling the emotion? Client: Oh, yeah. I feel it. Therapist: Okay. Where do you feel the emotion in your body? Client: Wow. I hadn’t really thought about it, but my shoulders get really tight and I start to feel warm, even just sitting here thinking about it. Therapist: Okay, great. So let’s explore what it would be like to open to all these emotional experiences, starting with the tightness and warmth you’re feeling. Can you allow those sensations to just be there, without judging them, without reacting to them, and instead opening and softening to them? Client: Okay [takes a deep breath]. Therapist: And is there a feeling that goes with the sensation?Client: I’m angry. No…I’m scared. I guess I’m afraid he doesn’t really love me. If he did, he would be more excited about seeing me—he would be on time. Or at least have the decency to call and let me know he’s running late. Therapist: So you’re scared he doesn’t really love you. Client: Yeah. I know it sounds dramatic, but that’s the thought I’m having. Therapist: Okay, good. Let’s practice watching your thoughts and letting them go for a few minutes. Client: Okay. Just tell you? Therapist: Yes. You can just say, “I’m having the thought that he doesn’t really love me,” and then let that thought go, and wait for the next one to arise. Client: Okay. I’m having the thought that “I’m not pretty enough.” Therapist: Okay, now let that thought go, and wait for the next. Client: Okay… I’m having the thought that overreacting,” and now I’m letting it go. “I’m Therapist: Good. Client: [Pauses] I’m having the thought that “He doesn’t need me as much as I need him.” That one’s hard to let go [sighs]. Therapist: That’s okay. Just acknowledge it by saying, “There’s a sticky thought,” and let it go. Client: Okay. Therapist: Can you identify an urge that goes with these thoughts? Client: Hmm. Well, definitely the urge to shake him and tell him off! Therapist: Okay. Can you try to just sit with that urge by observing and accepting it? See if you can allow it tobe just as it is? Maybe you can imagine making space to feel that urge without acting on it. Client: I’ll try. Therapist: [Pauses fifteen seconds] What’s happening now in your body? Client: It just kind of relaxed…and my mind isn’t going so fast. Therapist: So the tension you were feeling has relaxed? Client: Yeah. It’s still there a little, but way less. Therapist: Okay. And your thoughts are slowing down? Client: Yeah. I’m still having the thought “He doesn’t really love me”…but…it stopped feeling so “sticky” once my body relaxed. Kind of like they were connected to each other. Therapist: Right. So let’s stay with that thought for a moment. See if you can just acknowledge that thought, without reacting to it, without judging it, and instead just letting go of it. Client: Okay. Therapist: What’s happening now? Client: I am having the thought that “This is really different.” Therapist: You mean letting go of your thoughts? Client: Yeah. I didn’t realize I had a choice. Maybe I can do this when it actually happens. Therapist: That’s the goal. So where is your SUDS level in this moment? Client: Um… I think it’s around a 2 or 3. Therapist: Okay, great. Let’s wrap up the exercise. Take a deep breath in and let it out slowly as you open your eyes and come back to the room. Moment of ChoiceOnce clients understand how to practice mindful acceptance, you’ll want to explain how to locate the moment of choice. Locating the moment of choice is important for emotion efficacy because this is how clients find the space to choose how to respond to difficult emotions in ways that are effective and hopefully life enriching. The moment of choice is when clients will choose to use EET skills: emotion surfing (chapter 4), values-based action (chapter 5), relaxation and self-soothing (chapter 7), coping thoughts (chapter 8), and distraction and time-outs (chapter 9). You’ll want to emphasize that finding and using this “moment” is essential to increasing emotion efficacy. Following is a handout you can share with your clients to introduce the moment of choice. (For a single-page version of the handout, visit http://www.newharbinger.com/34039, or see Appendix C.) Moment of Choice As humans, we don’t have control over whether or not we have emotions. Emotions will arise naturally in response to what’s happening inside us and around us. But we can control how we respond to our emotions, and that’s where we find true emotion efficacy. This concept was illuminated by neurologist and psychiatrist Victor Frankl as follows: Between stimulus and response there is space. In that space lies our freedom and power to choose our response. In those choices lie our growth and happiness. (n.d.) How effectively we respond to difficult emotions depends on being able to locate this “moment of choice.” This moment is the time when you realize that you’re emotionally triggered, and you realize you have the power to choose how to respond. You might think of it as a “sacred pause” when you can either react, avoid, or try to control it—or you can choose a response that is life enriching.In EET, you’ll learn a variety of skills you can choose to use in your moment of choice to help you respond to your emotions in a way that brings you close to what you want to create in the moment. EET Model = Observe + Accept Emotions > Locate Moment of Choice > Choose EET Skill Therapist-Client Dialogue Example: Talking to Clients about Locating the Moment of Choice Therapist: So now that you know how to observe and accept the components of an emotion, you’re ready to practice locating the moment of choice. Client: What’s that? Therapist: The moment of choice is the moment you recognize your choice in the face of distress. It’s when you recognize you could choose a response that is conscious and authentic rather than letting your emotions run the show. Client: But what if I can’t find it? What if I’m still so upset after practicing mindful acceptance that I still act on my emotion? Therapist: It takes practice to locate the moment of choice, but it gets easier the more you try it. All that’s needed to find it is to pause long enough to realize you have a choice in how you respond. Does that make sense? Client: I think so. Therapist: Let’s try it. How about we try to locate the moment of choice using a triggering situation right now? Can you think of a triggering situation that’s happened recently? Client: Sure. Last week when one of my coworkers took credit for an idea I came up with. Therapist: What was the trigger, or the moment you realized this had happened?Client: She announced it as her own idea in the middle of an office-wide marketing meeting. Therapist: Okay, let’s go with that. Just close your eyes, and we’ll take a few minutes to get into the scene. Just locate yourself at the meeting and remember what she said, and let yourself get emotionally activated. Client: [With eyes closed] Oh, I’m activated! Therapist: Good. So as you think about the moment when you realized she was taking credit for your idea, what comes up for you? Client: I wanna reach across the table and strangle her! She knows how hard I’ve been working to get promoted. Therapist: And what did you do? Client: I got up and left the meeting. Therapist: Okay, let’s work with that emotion. Let’s begin using mindful acceptance starting with what you sense in your body? Client: Yeah… My heart is racing…um…my stomach is tense, really tense. Almost like I got sucker punched. Therapist: Okay, let’s stay with that sensation of tension for a moment. Just notice the size and shape of the tension, and see if you can allow it to be exactly as it is. Client: Okay. Yeah. It’s the size and shape of a grapefruit… Therapist: Good, now notice if there’s any temperature to it… if it’s hot or cold or neutral. Client: It’s warm. Therapist: Now, notice what happens as you accept the sensation and make room for it… Does it change or stay the same? Client: It’s relaxing a little. Therapist: Okay, good. Now see if you can identify a feeling label that goes with the sensation and the urge tostrangle your coworker. Client: Just…outrage. Pure and simple. Therapist: Okay, good. Now see if you can soften to that feeling of outrage… Make space for it and just allow it to be as it is. Client: It’s intense, but okay. I’ll try. Therapist: Okay, just allow it to be intense then. Continue trying to soften to it, lean into it even. Therapist: [Pauses for 30 seconds] What’s happening to the feeling now? Client: It’s starting to feel a little boring. Therapist: Boring? Client: Yeah, like I’m tired of focusing on it…and it’s not that strong anymore. Therapist: Okay, let’s move into thought watching. Client: I’m having the thought “She betrayed me and I shouldn’t have trusted her. I’m so stupid!” Therapist: Okay. Can you acknowledge the thought that she betrayed you and let it go? Client: I don’t want to let it go, but I’ll try. Therapist: It makes sense… Your brain thinks you need to hold on to that thought so you don’t get hurt again. But see if you can just acknowledge that it’s a sticky thought, and let it go. You can always come back to it another time. Client: Okay. Now I’m having the thought “I am so emotionally messed up.” Therapist: Okay. Can you see that’s a judgment thought, and just acknowledge it and let it go? Client: Okay… there’s a judgment thought…bye-bye! Therapist: [Chuckles] Good for you. Now let’s check in to see what urge goes with the emotion.Client: Hmm. Well, I still want to strangle her, but it’s less intense. Therapist: Okay, so can you just notice what it’s like to have the urge to want to strangle her? Can you just sit with it for a moment? Client: Okay. Therapist: [Waits 30 seconds] What’s showing up now? Client: Well, I feel less like strangling her… It’s a pretty violent urge. I’m a little embarrassed. Therapist: I understand. Can you just allow that feeling to be there without judging it? Client: Yeah, okay. Therapist: Staying with the urge, can you see if you can imagine not acting on it, and just sit with it? Client: Yeah…you mean like not leaving the meeting? Therapist: Exactly. Just observe and accept that you had the urge to leave. Client: Okay. Therapist: Now, can you locate the moment when you had a choice about that? Client: Well, I might have had a choice right then if I did these mindful exercises when it happened. Therapist: Right, can you see that moment? Client: I think so… If when I got outraged I had paused and noticed the moment of choice, I could have chosen to just stay in the meeting? Therapist: Right. By using mindful acceptance, you might have seen your power in the situation—in the moment of choice. Client: Yeah, I can see that. Therapist. Okay, take a deep breath and let it out slowly as you open your eyes and come back to the room. In our next session we’ll learn a new mindful acceptanceskill called emotion surfing that you can use to just ride out the emotion, instead of acting on it. Summary Following is a synopsis of content covered in chapter 3: Mindful acceptance is the practice of observing and accepting (distinct from avoiding, reacting to, or trying to control or alter) the four components of emotional experience through: sensation acceptance, feeling labeling, thought watching, and urge noticing. The moment of choice is the space between an emotional trigger and action, when clients can consciously and intentionally choose their response. Mindfully accepting emotional experience is essential to locating the moment of choice during an emotionally triggering situation. Exposure to emotional experience allows clients to develop more facility and flexibility with how they respond to triggers. Practicing mindful acceptance in an activated state will enhance learning, retention, and recall.