Rating the Emotions of Your Clients

About two years ago, Richard Davidson, a psychology professor in affective neuroscience at the University of Wisconsin-Madison, published a bestselling book called The Emotional Life of Your Brain (2012). One of the central elements of the book was the creation of an emotional assessment scale. The scale measured six different emotional styles that apparently all humans exhibit in one form or another. 

Now, what does all this have to do with addiction treatment? It dawned on me that in our attempt to really get a good assessment handle on our clients rarely do we inquire about the emotional style of a client. If we knew that style, what might be the possible impact on treatment or even the recovery process? Having a reliable procedure to assess a client’s emotional style might shed light on heretofore-unseen dimensions of our clients with potential treatment opportunities. 

This column will outline Davidson’s six emotional styles and then offer assessment possibilities, if not addiction treatment prospects, that you might not have considered before. To set the stage for all this, we first need a brief update on feelings. 

To put a person’s emotional style into perspective, consider that emotions can be classified in three different forms. “State” is the smallest and most fleeting unit of emotion. It generally lasts a few seconds and is often triggered by an experience, be it someone cutting in line ahead of you or completing all your progress notes for the week. “Mood,” on the other hand, is more persistent and can continue for hours, even days, as in “He’s been in a really bad mood.” Finally there’s “trait,” which persists for months if not years. Recall those individuals who never seem to be upset about anything; the happy-go-lucky types or the perpetually angry folks and my favorite, the grumpy old guys. 

All that leads to emotional styles. They are not like someone’s personality, but rather a consistent way of responding or reacting to life’s experiences. According to Davidson, science has even identified different specific emotional style brain signatures where these styles seem to originate. 

At the outset, it needs to be clearly stated that these six emotional styles did not just pop out of Davidson’s head. He did a great deal of research on this subject, and placed all that data into a useable clinical form. That’s a big reason for why it’s being used in this column. These dimensions are laid out on a scale from those attributes of doing well on the dimension to not doing so well. So, in the order as described by Davidson, the styles are presented here. 

In terms of engaging life’s problems, the range on the resilience dimension extends from those who are fast to recover from such tribulations to those who are slow to recover. For example, those who are fast to recover will shake off setbacks, amass their tenacity and determination to press on, are able to recover quickly from arguments with partners and supervisors, and respond to setbacks with renewed energy and grit. Those on the slow to recover side of this resilience scale suffer meltdowns in the face of life’s difficulties, cannot seem to make appropriate changes, feel helpless or simply give up. 

Now if I were conducting an intake on a substance use disorder (SUD) client, I would want to know the resilience capacity of that client. It would give me distinctive treatment directions that I might not have considered in the past. For example, I could introduce an array of coping skills to clients who are on the slow to recover end of this dimension.  

The range of the outlook dimension extends from negative to positive. Those with the negative inclination lean to the cynical and pessimistic side of things. They struggle to see anything positive in their life, and if something positive does occur in their life they cannot sustain it. Essentially they are the negative, gloomy types. Those on the positive end of this spectrum tend to maintain a sunny disposition despite the dark and emotional clouds hovering over their heads. They seem to maintain high levels of energy and engagement even when things are not going their way. 

As with the previous dimension, I would want to know where my client rates on this scale. It might describe certain client behaviors and cognitions better that traditional SUD treatment now can. Knowing the rating, I could search the literature to find the appropriate treatment interventions for the negative style clients, which might help with a recovery process.

The range for the social intuition dimension extends from puzzled to socially intuitive. Those on the puzzled end of this element are mystified or even blind to the outward indications of others’ mental or emotional state. They cannot read facial expressions well or interpret other social cues, and such individuals may have autistic traits. At the other of this scale are those who are socially intuitive. They can read body language well, gauge feelings from the tone of one’s voice, and seem to have an uncanny ability to pick up subtle human cues of all types. Folks at this end of the scale typically make good therapists. 

As with the previous dimensions, understanding a client’s particular social intuition parameters could give SUD counselors insights into why a client might have problems interacting with other individuals or have the ability to give solid feedback in group sessions. If the intuitive deficits are pronounced, the SUD counselor can again do some research and apply the findings to assist the client with this important dimension.   

In the self-awareness dimension the range is from self-opaque to self-aware. For those on the opaque end of this dimension, they do not to have an ability to read their inner feelings and thoughts. They are the clients who seem oblivious to their own anxiety, cannot account for an outburst of jealousy, and feel threatened but cannot account for those feelings. Essentially, they are blind to these and other feelings. They are not in denial, as in getting honest with oneself, but are honestly unaware of the emotional cues that arise within themselves. At the self-aware side are the clients who are quite conscious of thoughts and feelings. They know the real reason for their outbursts at a partner or at children. Understanding themselves helps them understand others. This is an important element in empathy. 

Knowing self-awareness levels in SUD clients could enhance treatment possibilities, especially emotional insight to those who lack this dimension. 

Sensitivity to context ranges from tuned-out to tuned-in. The extremes on this range denote what this style is about or how one is adapted to the conventional rules of social interaction. At the tuned-out end are individuals who are unaware of the inherent rules that govern most social interactions. For example, someone at a funeral playing a video game on their cell phone or those who are puzzled when others tell them their behavior is inappropriate. Examples at the tuned-in end include those who moderate their voice at a restaurant or when using a cell phone, or show good manners and respect for those around them. 

Knowing a client’s sensitivity to context can tell you a lot about how a particular client is going to relate to others, especially in the early phases of a recovery program. This will show itself in how clients act in a Twelve Step meeting or in a group session. One can only assume that years or decades of substance abuse will have eroded this style. This will point to the need to assist those at the tuned-out end with improved interaction skills.

The extremes in the attention style range from being unfocused to being focused. Those at the unfocused end of attention often find their thoughts dart from subject to subject, are distracted by emotional impulses, and find such distractions holding them back from completing tasks and staying balanced. At the focused end of this spectrum individuals can screen out emotional distractions, and despite such inside and outside distractions remain focused. They have the ability to filter out such commotions. They end up getting tasks completed.

Equipped with such knowledge, the SUD counselor might better account for treatment tasks that are completed versus those that are not. In addition, the counselor might be able to account for why one client is making strides in recovery while another is not. The former is able to attend well to the business of recovery, while the latter is having problems.   

Now for the astute reader, the question of how one measures these styles has had to arise. Well, it just so happens that Davidson has created a measuring process. It is a set of questions for each style with a method to score each style. However, outlining that process would extend well beyond the usual limits of this column. So, for those of you who find this emotional style intriguing, consider purchasing Davidson’s book—it’s all in there. There’s even a whole chapter of recommendations to help change the level of each style. 

I searched for SUD-relevant research on utilizing these emotional styles to our field and could not find anything. The search was not exhaustive, but if such research is indeed lacking it leaves open a number of possibilities for the adventurous researchers among you. A couple of easy research possibilities would include a survey of SUD clients to note any style that might dominate in that sample, or a survey of those with five or more years of sobriety to ascertain a particular style, or to discover a style for those who constantly relapse.  

As always, I remain interested in such research.

Davidson, R. J., & Begley, S. (2012). The emotional life of your brain. New York, NY: Plume.