Whatever we pay attention to…..our emotions follow. Sometimes clients need the ability to shift their emotional state before they can connect to what really matters and respond from their values. Several skills taken from Dialectical Behavioral Therapy (DBT) allow clients to dial down their emotions in the moment of choice. For example, through relaxation and self-soothing, clients can downshift their levels of activation. Using radical acceptance and coping thoughts, they can learn to shift perspective and defuse from painful content. And using distraction or time outs, they can practice shifting attention away from emotion triggers so they can recover and reconnect with their values.

Mindful Coping in EET is practiced differently than DBT coping skills in that they are only used after the client first practices Mindful Acceptance— observing and allowing all parts of the emotional experience. This allows clients to become more skillful at understanding what they need to to flexibly navigate difficult emotional experiences, even when they can’t yet identify values-based action.


Each EET session focuses on one or more of five treatment components that build on each other through the protocol.  This blog explains the first component of EET: Emotion Awareness

Emotion Awareness is the ability to make present-moment contact with emotion. Emotion is experienced through its four components, and clients learn to recognize how it manifests through thoughts, feelings, sensations, and urges.  Sometimes clients know they are experiencing an emotion, but they’re not sure what it is. Or they may know the feeling label for the emotion, but not realize how it is manifesting through the components of sensations, thoughts and urges.

Through Emotion Awareness, clients develop an understanding of their trans-emotional process, by learning to identify and observe each component.  Emotion Awareness also helps clients learn to notice the origin or trigger of the emotion, as well as the typical lifespan of the emotion wave that results from the trigger. Having an awareness of one’s emotional experience and its process is the first step toward increasing emotion efficacy.


The underlying drivers of low emotion efficacy as we conceptualize it are emotion avoidance and distress intolerance. We define emotion avoidance as an unwillingness to experience difficult emotions, which then fuels distress and leads to more suffering.   

Distress intolerance refers to a person’s inability to experience intense emotions. Both of these maladaptive responses to emotions typically result in responses that do not serve the individual in recovering from intense emotion triggers, or choosing responses consistent with their values.

Often these drivers work in tandem to leave people feeling that they don't have a choice when they get emotionally triggered.  Emotion Efficacy Therapy (EET) targets these drivers through 5 components: Emotion Awareness, Mindful Acceptance, Values-Based Action, Mindful Coping and Exposure-based Skills Practice.