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Six Stages of
Anxiety... a Conflict Model of Emotion
at the end of this Manual for reproducible
Client Worksheet #2)
Conflict Model of Emotions
Emery has developed a Conflict Model of Emotions, in which he has attributed Six
Stages or steps in the creation of anxiety.
1. The sequence starts
with a mismatch between your client's perception of reality and their expectations.
This gap between perception and expectation sets the stage for emotions.
2. Your client then attempts to fill in the gap by activating memories
associated with the present contextual cues. In the case of anxiety, people activate
3. Using their memories as building materials,
your client creates an image to fill in the gap. He or she creates an image that
is usually an exaggeration of the current situation. This image building occurs
in the right hemisphere of the brain.
4. The image is then transmitted
to the left hemisphere, where it activates your client's beliefs and thoughts
in the form of an analytic code. This "code" then reacts to the incoming
5. The image and thoughts clash. This clash causes a stopping
of the accepting or processing of incoming information. This creates a psychological
response that your client experiences subjectively as a feeling.
The feeling is a kinetic self-signal for your client to take action. Once
he or she takes this action, the self-signal stops. Because the feeling experienced
often is an unknown, this sets the stage for a spiraling of emotions.
According to Michelson, a socially
anxious client experiences these Six Stages as the following:
encounter an unknown situation. For example, they may have to go to a social gathering.
2. The situation cues in past frightening memories. They recall past social
gatherings that have negative memories.
3. They then create a frightening
image, such as being awkward and looking foolish.
4. This then activates
their belief and self-statements that they have to have others think well of them.
5. They stop processing current reality and focus instead on the danger;
the clash creates the experience of anxiety.
6. This then becomes a
self-signal to escape the social situation or to tense up. This behavior increases
the unknown aspect. This in turn reinforces the belief that there is something
to fear. These all act to add to the memory pool of frightening events.
Because each Stage is necessary to produce and maintain the emotion, intervention
at any of these six stages can disrupt the emotional chain reaction. The rest
of this section will discuss the clinical implications for each of these Six Stages.
One: Facing an Unknown
Anxiety = Unknown X Importance. In short,
this formula means the greater the unknown and the greater the importance your
client attaches to it, the greater the anxiety. As mentioned earlier, fear is
the result of perceptual mismatch. The cue to start the production of anxiety
is a mismatch between your client's expectations and his or her perceptions. Biologically,
humans appear to be wired to respond with fear when reality fails to match their
expectations. Hayward says, "The fear reaction is aroused whenever the organism
has a perception which does not match its anticipation of what it should perceive
in a particular situation." In evolutionary terms, it is more efficient to
wire the nervous system to respond to the unknown than to the many possible dangers.
Because people live in a world of unknowns, they are surrounded by a circle of
fear. The fear is triggered when your client steps out or is pushed out of his
or her familiar surroundings and confronts an unknown situation.
reason, anxious clients seek familiar people and places. The familiar situations
provide where they have a sense of control, approval, and competence. The client's
domain is made up of what is known to him or her. Behavioral intervention works
because it allows your client to know what was previously unknown. Knowing destroys
fear, whereas avoiding what one fears increases the unknown and so increases fears.
Any procedure that helps people become familiar
with what they fear will be beneficial. Self-efficacy training, for example, works
by having clients approach and master what they fear. The more one knows about
something, the more confident one feels. Similarly, choosing to experience and
know one's anxiety reduces it.
Stage Two: Activating
When clients confront novel situations, they
rapidly and unconsciously search their memory for similarities from the past.
Their initial panic is due to failure to find any similarities. The specific memories
activated depend on your client's mood and contextual features of the current
Gordon Bower developed an associative network theory
to show how emotional memory units are associated with current events. Activation
of this emotional memory unit aids retrieval of events associated with it. And
activation of this emotional memory unit primes emotional themes for use in fantasies
and perceptual categorization. The emotion memory is in the right hemisphere,
the analogue code. The person's perceptions of the world are colored and
twisted by past emotional experiences. On the Audio Tapes that accompany this
Home Study Course, this perceptual categorization will be referred to as cognitive
maps or frames of reference.
In the case of anxiety, memories of vulnerability
are activated. Their memories are the result of the person's early learning
history and center around three general concerns such as, approval, competence,
and control. Each concern is directly related to self-esteem. A threat to any
one of the concerns is a threat to self-esteem or self-respect.
specific memories that are activated play a significant role in which emotion
is created. Because of the power of the memories that are activated, clients appear
to have multiple personalities. For example, the client's subpersonality when
he or she is depressed is markedly different from his or her anxious subpersonality.
The emotional memories that are elicited
are associated with specific body reactions. A client who acts fearful is more
likely to activate fearful memories. This is why a useful intervention is to have
the client engage in a behavior associated with mastery. The use of teaching stories
and metaphors is a way to modify deep-structural memories.
the reworking of old images, a client can recreate the past. One effective
procedure is to rework old memories into more happy and satisfying outcomes. Similarly,
mastery experiences allow clients to build up more useful memories. A helpful
strategy is to have anxious clients attend to and record their success experiences
on a daily basis. Side two of the Audio Tape number two in the accompanying audio
tapes contains a "Video Time" exercise in which this method is explained
in more detail.
Three: Creating Images
Rather than seeing reality, people create
and see their image of reality. The unknown plus the memories set the stage
for people to start "what if-ing."... for example, "What if I go
crazy?" or "What if I die?". People tend to believe their self-created
images. "Availability" helps to explain this in so much as... whatever
springs to mind most easily is judged to be most probable and most believable.
Because of the tendency to believe what one imagines, "what if" becomes
"as if." Anxious clients, for example, believe and act "as
if" their frightening self-created imagery is true. They treat "what
if" ideas at a high level of abstraction like "as if" ideas. When
these "what if" ideas are real and concrete they are at a low level
of abstraction. If your clients know they are pretending, they experience mild
anxiety; if they forget they are pretending, they experience panic.
arises when people respond to the unknown by pretending something bad will
happen. Leventhatl cites evidence confirming a common clinical observation: the
anxious client functions well with real problems, but becomes immobilized when
confronted with unknowns. In unknown situations, anxious people create pseudoproblems
by pretending or imagining the worst. The anxious person's fantasy is consistently
worse than reality. One of the goals of therapy is to have the person see more
and imagine less.
A state of anxiety has a trance-like
quality and has several characteristics similar to a hypnotic trance:
construction of awareness or tunnel vision.
(2) "as if"
thinking or role taking.
(3) regression to an earlier state.
This trance-like state is partly due to a direct relationship between imagination
and belief: what one imagines, one believes , and what one believes, one imagines.
The person who is unable to imagine being in a car accident will believe the chances
of an accident are remote and may act on this belief and reinforce it by not wearing
a seatbelt. However, the person who can imagine a car crash will believe one is
likely and, in the case of a phobia, will reinforce this by avoiding driving.
The less aware your client is of their frightening
images, the more effect these images have. Teaching clients how to monitor
their images and detach themselves from them is an effective intervention. The
therapist can use different techniques to help clients modify frightening images
and create self-enhancing ones. The Audio Tapes that accompany this Home Study
course present numerous techniques to help your client modify thinking patterns.
Four: Activating Belief System
The images cross over to
the left hemisphere of the brain where they activate the relevant analytic code.
The emotional memories in the analogue code have a corresponding belief in the
analytic code. This belief is developed in response to the original experience.
For example, a client who has painful memories of being abandoned as a child may
have the corresponding beliefs. These beliefs are deep-structured and deal with
unacceptable life situations. Memories of early experiences that were never fully
processed or accepted remain and form your client's belief system.
beliefs are overcompensations for painful images. For example, a person's
emotional memory of being inferior to others may have a corresponding belief such
as "I have to be loved at all times" or "I have to be the best
at whatever I do." Paradoxically, this overcompensating belief often creates
precisely the experiences your client is trying to avoid.
conflict is between images of current events that are filtered and colored by
past memories or analogue code. Thus, automatic thoughts are derived from
early beliefs about the world or analytic code. The conflict is created by labeling
events in: 1) an unacceptable way, "I'll die"; 2) by exaggerating
the situation, "It's awful"; 3) by direct self-instruction, "I
have to get out"; or 4) by minimizing ability to deal with the new information,
"I can't stand it."
consists of reactive thinking. The person's conscious thoughts react to
incoming images; for example, "I can't stand it" or "This is awful"
or "This should not be". Reactive thinking, rather than stopping the
intrusion of frightening images, escalates the flow of these images. Reactive
thinking is based on the premise that others are responsible for one's thoughts,
feelings, and actions and one is responsible for other's thoughts, feelings, and
The role of reactive thinking is crucial in understanding
and treating anxiety. This form of thinking is characteristic of early development,
where clients cement outside events to their feelings. They make the conceptual
connection that other people or outside events are causing their feelings. This
parallels concepts derived from the physical world, where sticks and stones can
actually hurt someone. Such clients project the cause of their experiences onto
others and the cause of these others' experiences onto themselves. For example,
socially anxious people believe they are responsible for what others think of
them. They also believe others are responsible for their anxiety.
People are biologically, developmentally, and socially
prone to reactive thinking. Developmentally, the brain when confronted with
emotional trauma, is unable to respond differently until a child is around 11
years old. Reactive thinking is necessary for socialization. Helpless children
need a manipulative system to get others to help them survive. Reactive thinking
helps evolution. Cues lead to automatic feelings and responses that lead to survival.
Also by recalling bad experiences, this is more economical because fewer bad events
happen to remember. This parataxic type of thinking is in operation when children
do their early learning. Each child believes he or she is the center of the universe.
Because of the initial effect, what the person learns first is what stays.
Children lack reversibility - the ability to uncouple events from strong
feelings. Their early-deep structure beliefs are based on a reactive premise.
The relevant beliefs in the analytic code are reactive beliefs Children use the
physical world as a frame of reference and confuse this with the psychological
world. But the physical world is a world of change and control; the psychological
world is one of selection and choice.
People and things change physically;
this involves a transfer of energy. Psychologically, however, people create
different experiences by making both aware and unaware choices. People's efforts
to change themselves usually lead to resistance and frustration. As you know,
the client thinks of change and control because that is what he or she sees happening
around them. They also want to change and control things because this implies
permanency and safety from anxiety.
People appear to acquire much
knowledge of the world through passive association. For example, the advertising
industry is based on the power of associative learning. Through associative or
reactive learning, people weld together feelings and events. Much of people's
thinking is unscientific. Their thinking is based on this correlational reasoning
rather than experimentation.
People maintain reactive thinking
largely because they are unable to see how they create their own negative feelings.
Clients feel the following must be the cause of their problems: because people
do not want them. The client cannot see how they created the "problem."
In addition, as you know they feel they cannot get rid of the problem. The client
generally assumes that something else must be causing his or her feelings. Projection
plays a part because others seem to be creating your client's experiences. Therefore,
the client feels he or she is also creating the experience for others. Any event,
internal or external, that can be coupled with a specific feeling that triggers
the creation of emotion, appears to be the cause. Because some internal or external
event always precedes an emotion, that event is assumed to be the cause. How can
this basic principle be reapplied to one of your past or present sessions? Sometimes
the basics are easy to overlook and may be the focus for your next session.
Thinking versus Thinking Based Upon Choice
Clients look at the most
important cues and ignore the context, thereby reinforcing the idea that events
are caused by feelings. Reactive thinking is unverifiable. The reason for this
unverifiability is, when in the reactive thinking mode, your client cannot logically
prove that others do not cause one's feelings.
The brain does not give
notice that there is a different way to think. Many clients lack the learning
opportunity to think in different ways. Others have difficulty moving away from
reactive thinking. Agree? However, after your client has practiced reactive thinking
on thousands of occasions, he overlearns this way of thinking. For example, PTSD
traumatic events can lock the client into believing that the events cause feelings.
Some type of neurological pathway between stimulus and response may also develop
because of overlearning.
People learn through modeling that outside
events cause feelings. Cultural distortions support reactive thinking. Mass media,
like television, music, and newspapers all reinforce the idea that others are
responsible for your client's feelings.
Reactive thinking is used
for social control. Organizations, institutions, and parents all use this system
to control and manipulate those under their control. Further, everyday language
reinforces reactive thinking by encouraging people to assign psychological properties
to properties that are actually one's own... for example "The picture is
beautiful" rather than "I feel the picture is beautiful."
Social demand characteristics also come into play. By this I mean that
a person tends to respond as others are responding. Sensitivity to others' facial
and other nonverbal expressions often triggers reactive thinking. People are socialized
to rank others above or below themselves directly. They use others' reactions
as mirrors. These mirrors reinforce reactive thinking.
defenses maintain reactive thinking. An example of reactive thinking is a
person who cannot tolerate being wrong when confronted with old stimuli. An example
of an old stimuli is assessing his or her family and responding in an old conditional
way. People who have not become skilled at utilizing thinking based on choice
revert to reactive thinking when under pressure. Their insecurities lead them
to hold on to old ways of thinking. Through rationalization and selective attention,
people see what they believe to be true.
Therapists can help anxious clients deal with issues of approval, control,
and competence by adopting more adaptive beliefs. People can, for example,
learn to substitute the concept of choice for that of control. Similarly, people
can learn to adopt and use more esteem building beliefs.
use a variety of strategies to help clients start using thinking that is based
on choices, not reaction. Most clients can learn to move into the choice system
relatively easily. However, clients can just as easily move out of it and back
into the reactive system. As you know, the more your client practices, the easier
and more automatic this flexibility becomes. Clients who appear to have changed
may in fact have simply reinforced a new deep-structural belief system -- a belief
system that allows them to make the shift from reactive thinking to "choice
mode" more easily and more often.
Five: Blocking of Acceptance... Creating Subjective Feelings
clash between your client's images and their reactive thinking stops them
from processing information and creates, instead, the experience of the feeling.
An example is the shudder response. The client has a frightening image and then
makes an evaluation of it, for example, "It's terrible". The resulting
clash creates a sudden vibration through the body known as the shudder response.
But when your client skips the "shudder" response, he or she imagines
something bad happening, but accepts this image without fighting it and there
is no corresponding emotion.
The above model suggests that people process
or take in information about the world through their acceptors. The concept
of "acceptors" is a hypothetical construct. People assimilate an uninterrupted
stream of consciousness about internal and external events. They absorb or remember
useful information and eliminate the rest.
In summary, salient information
about an event is first filtered through a person's emotional memory system or
analogue code in the right hemisphere of the brain. This is out of the client's
awareness. Past anxious memories color the event and help create the images. The
information in the form of rapid images then goes to the left hemisphere of the
brain. This is where conscious awareness is checked against the belief system
or analytic code.
Normally, the information is then processed from the
left hemisphere of the brain back to the long-term memory in the right
hemisphere. In the right hemisphere, the client assimilates or remembers useful
information and eliminates or ignores the rest.
Working It Through...
Being "in the flow"
When people accept reality, they feel "in
the flow" so to speak. Like the workings of the digestive system, the process
goes unnoticed unless it is malfunctioning and creating a problem. However, when
people reflect their images of reality, they feel "stuck," "blocked,"
or "conflicted." Acceptance means taking in information about the world.
When this process is working, people say they are "taking it easy" or
"taking it in stride"; when the process is blocked, they report, "I'm
taking it poorly" or "I can't take it."
unimpeded through the acceptor unless the person has a conflict with the incoming
information. Such a conflict stops the acceptance process, and the person
goes into a spiraling state of resistance or emotional distress. Anxious people,
for example, have trouble "taking" their anxiety. An accumulation of
big and small setbacks can block a person's acceptor, and a client who is in a
state of resistance has trouble accepting anything. A client who does accept information
he or she has been fighting often experiences a physical change, feeling clearer,
lighter and more energetic.
The conflict that shuts down acceptance
occurs in the left or verbal hemisphere of the brain. This conflict occurs
when the memory or analogue code clashes with the abstract code or the unknown.
This process is characterized by rapid automatic thoughts and a narrowing of perspective.
When a client's acceptor closes down, his or her awareness becomes constricted
as he or she overfocuses on the danger or problem in the environment.
Colin Wilson states, The "worm's eye view" of the left brain
is negative by nature. The "bird's eye view" of the right brain is positive
by nature, revealing vistas of meaning and interconnectedness that are invisible
to the worm. Narrow focus and racing thoughts encourage a client to further distort
reality. Thus, your client has a less clear picture and anxiety builds. The end
result is the information your client has about the anxiety itself goes unprocessed.
Because anxiety is caused by a self-conflict,
as you know, your client needs to learn how to let go or accept current reality.
He or she also, however, needs to know the difference between surrendering internally
and giving up to external events. Many people confuse accepting the reality of
the moment with resigning themselves to circumstances. Acceptance is decreasing
the emotional "charge" around the event.
Many different acceptance
strategies can be used. One strategy involves working the information through
the acceptor by simply reviewing it systematically. These range from the analytic
working-through process to behavioral flooding procedures. A straightforward method
would be to have the client repeatedly review emotionally painful material. This
can be seen as a deliberate way of getting and processing the information to result
in acceptance. Clients suffering from emotional disorders appear to be trying
to do this involuntarily. Your client may, for example, have a great amount of
motivation to discuss the material or have painful intruding daydreams or recurrent
nightmares. One client repeatedly told herself, "My father is dead"
until she accepted this fact. Showing anxious clients how to take a more reflective
and balanced view of the situation by answering their automatic thoughts stops
the conflict and the manufacture of anxiety.
One of the first clinical steps involves helping people stop the spiraling effects
of anxiety. One such acceptance strategy is the five-step AWARE strategy, developed
by Emery. The goal of the AWARE program is to help your client to accept and know
his or her anxiety by remaining present in context of the situation. Duplicate
the following, sketch it on a pad in a session for a client or on chalkboard or
flip chart. The AWARE strategy:
1. Anxiety is welcomed; deciding
to be with the experience.
2. Watching anxiety as an observer, separate
from the experience.
3. Acting as if one is not anxious.
Repeating acceptance; create affirmation. "I can handle this." "I
5. Expecting the best and accepting future anxiety by
giving up the hope that the anxiety will never recur and connecting that with
trust in one's ability to handle anxiety.
Another strategy to short-circuit anxiety is to have your client experience or
receive the brain's self-signal. Your client feels the anxiety for 45 to 60 seconds.
However, during this time they do not try to fight or change it, and without feeding
the anxiety any frightening thoughts or images.
Your client's subjective feelings motivate them
to take some action; for example, with anger, to attack; with
depression, to shut down; with happiness, to approach; and with anxiety,
to flee or protect themselves. Once a person takes this action, the motivating
emotion starts to disappear. However, the beliefs that help create the emotions
are strengthened. Avoidance, for example, decreases anxiety and fear. Anxious
clients often reinforce the motivating powers of anxiety by using it as self-motivation
or self-manipulation. They unwittingly use anxiety to motivate themselves to take
some action. A person, for example, may imagine failing a class and ending up
as a homeless person if he or she does not finish a project. This scenario creates
anxiety, which motivates the person to take action.
Clients can be taught to switch from a motivation based on feelings to one based
on choices. They can use the ACT formula (Emery) to do this: Accept
current reality, Choose what you want, and Take
action to get it. This permits clients to move out of the reactive system into
the choice system. A client accepts the situation as it is. The client then chooses
the experience he or she wants to have, and acts as if he or she is having this
experience. For example, socially anxious people can accept their feelings and
lack of social skills. The client then has a feeling of confidence for upcoming
events, and acts as if he or she is confident when they are in the social situation.
Your client learns that instead of using anxiety as motivation, they can do the
task directly. (The preceding was adapted from Beck.)
Reflection Exercise #2
The preceding section contained Six Stages in the
Creation of an Emotion. Write three case study examples regarding how you might
use the content of this section of the Manual in your practice.
What are six stages in the creation of emotions? To select and enter your
answer go to .