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The Self-Empathy Worksheet

When a strong feeling takes over — anger, fear, shame, sadness — it's hard to find what you actually need underneath it. This worksheet is a structured path from the reaction to the need, drawn from the practice of Nonviolent Communication. Work it after a hard moment, when you're calm enough to look back.

When to use it: Use this after a reaction, not during one. The goal is to understand what happened in a way that points toward a doable request — to yourself or to the other person.


Step 1 — Observation

What did the person say or do that triggered your reaction? Describe it without judgment — the way a video camera would capture it, just facts.

What actually happened (camera-style, no interpretation):

______________________________________________

______________________________________________

______________________________________________


Step 2 — Judgment (Out)

Be honest. What are your judgments about the other person? Get them on paper so they stop running in the background.

My judgments about the other person:

______________________________________________

______________________________________________

______________________________________________


Step 3 — Judgment (In)

Now the harder one. What are your judgments about yourself in this situation?

My judgments about myself:

______________________________________________

______________________________________________

______________________________________________


Step 4 — Feelings

Underneath the judgments, what are all the feelings you can detect? Name as many as you can find.

All the feelings I can detect:

______________________________________________

______________________________________________

______________________________________________


Step 5 — Empathy (In)

What did you want in that situation? What did you need? What were your intentions?

What I wanted / needed / intended:

______________________________________________

______________________________________________

______________________________________________


Step 6 — Empathy (Out)

Now stretch toward the other person. What might THEY have needed?

What the other person might need:

______________________________________________

______________________________________________

______________________________________________


Step 7 — Request

Land somewhere doable. What's a specific, concrete request you can make — of yourself, or of the other person?

My specific, doable request:

______________________________________________

______________________________________________

______________________________________________


Truths to Remember

Hold onto these: My intentions were good — if the consequences were bad, that means I used a mistaken strategy. Making mistakes means I'm human, not worthless. I learned a poor strategy; I can learn a better one.

Source: The self-empathy structure here is based on the Nonviolent Communication framework developed by Marshall Rosenberg. The prompts and wording are our own.

A gentle note: This worksheet is a learning tool, not treatment. If your relationship currently includes abuse, ongoing harm, or active crisis, please work with a qualified couples therapist instead.

Go deeper

Ready for more? These lessons pick up where this worksheet leaves off.

Questions?

Cassie Clayton

Welcome!

I'm Cassie Clayton.


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I hope to hear from you soon!

Cassie

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