emotion-focused care


Our vision of mental and emotional health increases the focus on emotions, values the emotional heart of service provision and minimises stigma by celebrating diversity.

“… the heart of our work is the hurt in our hearts”


Increasing the focus on emotional health

Emotions, such as grief, anger, fear, despair and shame are the core experiences of most “mental” health problems. This is especially so for people needing help with common life problems, such as bereavement or divorce, or with common mental health problems, such as depression or anxiety.

We also know that the biggest impact on biophysical health stems from lifestyle habits such as smoking, obesity or addiction where there is often an underlying mental and emotional health issue.

“… patients don’t care what you know until they know that you care”

Consultant psychiatrist Dr. Deji Ayonrinde (South London & Maudsley NHS Foundation Trust)

The emotional heart of service provision

The rational-technical approach of science has brought about enormous technological development, and because of this we have assumed that mental health problems can also be solved by this approach. Emotions, however, are by definition not rational and we need to accept that emotional problems require emotion-focused solutions. This is especially true of mental health services which need, first and foremost, to develop emotionally therapeutic relationships with their service users.

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We are, at heart, emotional beings who form emotional relationships with other people and with the world in which we live. This is especially relevant to mental health services, which need to focus on the emotional relationship that service users form with the service. Organisations therefore need to reflect on these relationships through, for example, asking emotion-focused questions:

1. What does this service feel like?

  • does it feel like your diversity is accepted?
  • does it feel safe?
  • does it feel like a refuge?

2. Do you feel genuinely cared for (while using the service and also afterwards)?

Some questions to ask about the service itself:

1. What could we – as service providers – do to make this service feel:

  • more accepting of diversity?
  • safer?
  • more like a refuge?

2. How can we work with our staff to ensure that they genuinely care for the people who use our services? How can we support them when caring becomes more difficult?

Minimising stigma by celebrating diversity

Stigmatisation is still a common reaction to mental health problems, which remain surrounded by prejudice, ignorance and fear. This causes a great deal of emotional distress for service users. The current disease model of mental ill-health is founded on the idea that people should fit into a standard for what is normal – with diagnostic labels describing the faulty and defective. In reality, however, most people who experience “abnormal” symptoms live “normal” lives – research has concluded, for example, that up to 28% of the general population hear voices that other people do not, but only a few people find these voices problematic.1

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This is one example of “neuro-diversity”, but there are many, many others. Highly creative people, for example, often have quite “abnormal” ways of knowing – Einstein “thought” partly with his muscles and many people with autism are highly creative. As social beings we all want to feel accepted and respected and perhaps this is why we tend to deny our diversity in order to fit in. We need, however, to accept how diverse we really are and find ways to support people to accept and value our inherent diversity.

Also see “Developing services that don’t rely on an increasingly complex system of diagnostic labelling” (“A coherent system” theme page).

1 “Hearing voices is an auditory hallucination that may or may not be associated with a mental health problem. It is the most common type of hallucination in people with psychotic disorders such as schizophrenia. However, a large number of otherwise healthy individuals have also reported hearing voices.” See here.

It is estimated that between 5% and 28% of the general population hears voices that other people do not – see de Leede-Smith, S. and Barkus, E. (2013). A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals. Frontiers in Human Neuroscience, [online] 7. Available from here.

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