Addressing the most superficial level is typically the least anxiety provoking for most patients. This can be seen as similar to a supportive style of psychotherapy. By contrast, continuously focusing only on the fourth level can be quite an intense and overwhelming experience for many patients,

many people are quite uncomfortable with an honest, open, and direct discussion of their feelings for the person they are talking with.

There is a striking parallel between initiating a new romantic relationship in her personal life, and recently initiating the therapeutic relationship.

three lines of information (i.e., what I hear, what I observe, and my emotional reaction) about a situation in order to synthesize a provisional understanding

Thus, the very act of observing oneself in detail helps calm people down and helps reduce the intensity of whatever emotion

Due to the limited capacity and selective nature of attention, it is very difficult for the human mind to focus on more than one task at a time

engaging the aspect of one’s mind that observes oneself (coined the observing ego by Sigmund Freud in 1933).

‘‘Try to paint a picture of it for me with your words, using as much detail as you can.’’

step—describing the emotion in abstract terms (e.g., using metaphors or similes)—to