Michael Korson, MFT Blog

Frampton Comes Alive (in Psychotherapy)

“More specifically, the analytic task of helping the [patient] become more fully human involves facilitating the patient’s efforts … to experience a greater range (and play) of thoughts, feelings, and sensations that are felt to be his own and that are felt to have been generated in the context of his own present and past relations with other human beings (including the analyst).” -- Thomas Ogden, MD

The quotation above is from one of the preeminent thinkers about psychotherapy today, Thomas Ogden, a favorite writer of mine.  What he expresses is what I have come to believe about the aim and reach of psychotherapy: our ultimate goal is to help the person “become more fully human” by becoming more fully him or herself.  The emphasis is on expansion and fluidity: greater range and motion.  In this way, psychotherapy is more about addition than subtraction.  While clients come to see me with various specific problems – relationship difficulties, anxiety and depression, substance abuse, career decisions – and we, of course, address these issues to find real solutions, there is something else going on as well.  Like some computer program running unobtrusively in the background, in the background of our work is this attempt to find ways for the client “to experience a greater range (and play) of thoughts, feelings, and sensations.” In other words, for the client to feel more alive in his life, more engaged and connected to his vitality.

At the core of the issues that clients bring in is, I believe, this problem of not feeling engaged and fully alive.  Depression and anxiety (while complicated conditions with various factors) may be seen in this light as symptoms that arise from disengagement with one’s life.  Problems in relationships and problems with substances may also be seen as symptomatic of this underlying problem.  Often my work with clients shifts in focus from examining a specific symptom, such as depression or addiction, to looking at what obstacles there are in living a fuller life.

I believe that through the modality of talk therapy, the client not only comes to understand himself better and gain more options for how to live life, but also experiences a greater engagement with life. The “talking cure” is a phrase associated with Freud, but was actually dubbed by Bertha Pappenheim, a.k.a. “Anna O.,” who became Freud’s first psychoanalytic patient.  Talking involves relationship; and relationship, as one client of mine said about dealing with his depression, is good medicine.  Relationships, especially when marked by trust, generate (as Ogden says above) awareness and expression of a person’s thoughts, feelings and sensations.  This is what happens in psychotherapy.

There are many reasons why a person may experience some detachment from his vitality or feel trapped in myriad ways in his life.  It may be that there have been serious deficiencies in in a person’s past relationships, traumas big or small, that impeded and did not facilitate development.  Psychotherapy provides for an intimate relationship to stimulate the process of  uncovering more depth and breadth of thought and feeling.  I have experienced clients, including those who have been very depressed and shut down, feel and express more vitality through the course of our work.  The process is not quick; it takes time.  However, it is very rewarding to see.

Sometimes this change in a client is signaled by language he or she uses in sessions. There is often more of a sense of playfulness (play embodies the vitality of life); a person is more creative in his ideas; and his language may become more symbolic and metaphorical.  And of course we can often see this person more engaged in his life outside of my office -- in his relationships, work and play.

Oh, about the title of this post.  Some of you old enough will recall the very popular live album in 1976 Frampton Comes Alive!  I do. I’m playing with the title to suggest that in psychotherapy clients come alive – they experience, feel and think more fully. They engage with life more fully.  (Playing the guitar or singing is optional.)

Ogden, T. (1997). Some thoughts on the use of language in psychoanalysis. Psychoanlytic Dialogues, 7:1-21.

A Marriage Between Humans and Technological Advance

In keeping with my interest and focus on writing about the internet and its effect on human behavior, thinking and relationship, I read with interest a review in the New York Times of a book that looks at this very question. The reviewer’s first sentence expressed a similar interest as my own:  “I don’t know about you, but I’ve always found the debate about what our mobile devices are doing to us — to our behaviors, our manners, our minds — at least as interesting as reports about what we’re doing with these devices.”

The book he is reviewing is iDisorder: Understanding Our Obsession with Technology and Overcoming Its Hold on Us by Larry Rosen, Ph.D., a psychologist in California.  In the book, Dr. Rosen reviews the growing research and literature on the topic.  Clearly, the pervasiveness of the internet, its accessibility even as we are on the go using hand-held mini-computers, has the possibility of (or in some view has already) altering the way we interact and communicate with one another.  Some view this influence negatively; others see some possibility for enhancing communication and ways of relating.

The review sites some of the facts that iDisorder offers:  “Did you know that… 70 percent of those who report heavily using mobile devices experience ‘phantom vibration syndrome,’ which is what happens when your pocket buzzes and there’s no phone in your pocket?...Or that heavy use of Facebook has been linked to mood swings among some teenagers? Researchers are calling this ‘Facebook depression.’”

Two consequences of excessive internet use that the reviewer mentioned caught my eye.  The first has to do with what is being called “cyberchondriacs,” a phenomenon caused by the plethora of available medical data online.  I don’t know that I know any cyberchondriacs. But I do know that many of my clients talk about research they’ve done, often on medical conditions, on the internet. And I know that there is a wide disparity in terms of reliable information out there.  One such way in which all that available information may affect people is, I think, suggested by this new term.

And he cites a study on memory that suggests a decrease in this ability given a reliance on on-line information.  He says that this impact is being referred to as the “Google effect.”  I recall, some years ago, just what deleterious impact the introduction and use of the calculator had on my then fourth-grade ability to multiply.  I learned then first-hand that relying on some technology impaired the workings of my mind.

I know that some of my clients talk about their use and sometimes preoccupation with the internet.  For some, there are endless distractions possible which interfere with their lives, their relationships, their goals.  For others, there are gateways to communities and links to people available.  The topic is fascinating to me.  Clearly, there is a marriage, if not made in heaven, but in Silicon Valley and places like that, between humans and technology.  For better and for worse.

 

What We Talk About When We Talk Across Cyberspace: How We Relate in the Age of the Internet

There is perhaps nothing that can be said about modern life more true than observing the ubiquity of the internet. It is indeed everywhere.  People now meet through the internet for purposes of casual acquaintance, sexual encounters, and potential long-lasting relationships.  People plan their travel online (does anyone remember travel agents?).  People bank. People read. And, judging from the enormous profits generated by pornography on the internet (according to Forbes, $14 billion in 2001), people have sex through it.  Warfare is also now waged through cyberspace.

Many, including those in the psychological world where I work and travel, are thinking not only about this influence, but also about how this influence is changing human behavior and thinking.  A local psychoanalyst, Stephen Hartman, who tends to have a more favorable view, writes “cyberspace is creating a shift in how we experience and understand reality.”  MIT professor and psychologist Sherry Turkle, in an article published in the New York Times, agrees with Hartman on this point: “I’ve learned that the little devices most of us carry around are so powerful that they change not only what we do, but also who we are.” 

And while some writers are speaking favorably about these changes and the new possibilities of relating afforded by the internet, not all are sanguine about the changes.  In her article, Turkle bemoans the changes taking place. Her article begins, “We live in a technological universe in which we are always communicating.”  As a researcher, she has participated in studies examining how people use modern technology. But one need not be a researcher to see the new drive to communicate in daily operation. There was the driver I saw this morning texting from her car as she inched along in heavy traffic.  There were countless people on their phones walking down city streets. Recently two theatre goers I talked to were appalled by the texting being done during the performance by people in seats next to them. There is Facebook and Twitter.  Never before have there been so many ways in which to connect to others.

But what is lost in the process?  Dr. Turkle believes the answer is a lot: “And yet we have sacrificed conversation for mere connection.”   She sees conversation being replaced by “sips” of online connection.  She distinguishes that an online connection is not necessarily the same experience that two people have in a conversation. (She doesn’t make the point, but this seems similar to the difference between a friend and a Facebook friend.)  “We are tempted to think that our little “sips” of online connection add up to a big gulp of real conversation. But they don’t. E-mail, Twitter, Facebook, all of these have their places — in politics, commerce, romance and friendship. But no matter how valuable, they do not substitute for conversation.”  Let’s think about what constitutes a conversation: thoughts, emotions, reactions to the other.  Dialogue.  It can seem rare today that people actually talk, discuss, argue, implore in any thoughtful sense.  She poignantly writes, “A 16-year-old boy who relies on texting for almost everything says almost wistfully, ‘Someday, someday, but certainly not now, I’d like to learn how to have a conversation.’”

In the loss of conversation, Tuggle sees the loss of self-reflection. We use conversation with others to learn to converse with ourselves. Conversation is a model for internal dialogue. And it is also provides a way of reflecting.  It is through discourse, through talking, that one can better know oneself. As my clients often say, they can hear themselves think when we talk, and what they say often takes on a greater shade of reality.

It seems to me that Tuggle is writing about psychotherapy when she says “FACE-TO-FACE conversation unfolds slowly. It teaches patience. When we communicate on our digital devices, we learn different habits. As we ramp up the volume and velocity of online connections, we start to expect faster answers.”  There is something about patience when my clients and I meet.  Against the backdrop of this fast-paced, fast-food life, that seems refreshingly anachronistic. She also notes how in conversation, there is something active taking place, a way of “tending” to one another.  This is my experience as a psychotherapist. Of course, most of the tending is what I do toward the client.  Though as in any relationship, especially when talking about intimate matters of the heart and soul, there is some reciprocal tending as well.

I’m glad that psychotherapy offers a place where there is the opportunity for people to converse.  And I’m appreciative of people, such as Tuggle, who make space around the dinner table for the family to talk to one another. To talk about what is really important and matters, with one’s family, intimates, one’s therapist, and to use more than 140 characters at a time, is hopefully not an experience of the past.

In upcoming blog posts, I’ll write more about Stephen Hartman’s and others’ ideas about some of the more positive changes to the human psyche and ways of relating that technology fosters.

Musings on the Mind at Play

The other day I heard the neuroscientist Stuart Firestein on Forum echoing the philosophy of Socrates.  Mr. Firestein, the author of a new book called “Ignorance,’ argued that science is less about an accumulation of facts and more about embracing what we don't know.  He was talking about maintaining a view that the more one knows, the more one knows about how much one doesn’t know.  That the acquisition of knowledge only goes to highlight the infinitude of what is not known.  That seems especially true to me in terms of the mind – the area that I explore each working day with my clients. 

With all that is known about the mind these days through the discoveries of neuroscience, it seems to me to only highlight the mystery that exits.  Or as a client of mine recently said, “the mind is fascinating.”  Indeed it is.

I know that people come into therapy with problems to resolve: problems that are distressing and causing sometimes great suffering. Perhaps there are issues of addiction to address. Perhaps they are experiencing depression or anxiety which makes it hard to function on a daily basis.  Perhaps there is some recent or past loss to mourn.  In the process of addressing these serious problems, I find, given the way I work and my interest in exploring how the mind works, that we also engage in some play. In the psychotherapeutic relationships, our minds meet, explore and play.

This “play” may take many shapes and forms.  There is the play in the form of associations. This is the bread and butter of psychotherapy: the technique that Freud discovered and employed.  While my clients don’t necessarily freely associate, they certainly feel free to say what comes into their minds.  From there we explore where the links and bridges may be to the issues that distress them.  There is play that we engage with language. Sometimes we follow certain words with their multiple meanings, puns, and metaphors, to see what they reveal.  There’s play in talking about dreams.  There is the play of thinking together: the client and I putting out minds together.

Play is inherently expansive (just observe a child at play and the limitlessness of her imagination). And that is, from my point of view, one of the key goals for psychotherapy: that the client’s mind opens and new possibilities, options, and horizons become visible.  In the interview on Forum, Dr. Firestein talks about “reveling in mystery.” That seems to me a phrase quite appropriately applied to psychotherapy.  The mind is a mysterious place.  I just have to quote from the interview one more time: “You want to work on the edge, beyond what is known.”

Corrective Emotional Experience, Plus

Writing in 1946, Franz Alexander coined the term “corrective emotional experience” to describe what he thought of as the key aspect of psychotherapy treatment. In his work, he expanded on Freud’s discoveries of half a century earlier.  Freud maintained that people in a sense forget their traumatic experiences by repressing the memory of those experiences.  However, the psychic charge of that trauma remains and manifests itself in neurotic symptoms. Freud believed that it was through recalling that trauma, re-remembering, that healing was promoted and symptoms resolved.

Alexander maintained that in dealing with a person’s past traumatic history, it was not enough to have insight (memory) about that experience.  He believed that insight had to be accompanied by a new experience for the client which was achieved in the relationship with the psychotherapist.  Alexander wrote, “the main therapeutic result of our work is the conclusion that, in order to be relieved of his neurotic ways of feeling and acting, the patient must undergo new emotional experiences suited to undo the morbid effects of the emotional experiences of his earlier life.”

The term “corrective emotional experience” implies that in the therapeutic experience, a person has the opportunity for a different sort of emotional experience which can repair the traumatic influence of previous experiences.  In the safe and nonjudgmental atmosphere of therapy, a client can experience being understood, cared about, and thought about.  This experience is “corrective” for those who come into therapy having had key experiences in their past that were vastly different. For those who have experienced some sort of neglect,  harsh criticism, or forms of abuse, the therapeutic experience provides a healing alternate experience. This is true for those who have suffered explicit abuse, but is not restricted to the severest forms.   The notion isn’t, of course, that one can go back and “correct” or change that earlier experience.  Rather, that the new experience, found in the therapeutic encounter and then fostered in other relationships in one’s life, can help displace the residue of the past.  That residue may take the form of beliefs a person has about others (people are essentially critical or incapable of understanding) or about oneself (one is helpless or powerless).  From this new therapeutic experience, a person experiences and can thus believe that he can be understood, that others do care, and that he matters.

This corrective experience is also possible when the client does not feel understood or cared about. Often in psychotherapy, as in the rest of life, an interpersonal conflict may emerge.  The client may feel judged or criticized by something that the therapist has said. Or the client may be feel hurt by what the therapist has not said.  He may feel that he is not understood.  In these situations, the client has the opportunity to express his feelings of hurt or rejection and be met by an encouraging and receptive response.  I believe a great deal of corrective emotional experience comes from such encounters when a client can tell me that he felt misunderstood or judged.  In those situations, we have the opportunity to work out that conflict.  More than likely, in experiences in his past when he felt similarly, there was not the chance to express himself, at least not without the possibility of retaliation or rebuke.  Alexander wrote, “Re-experiencing the old, unsettled conflict but with a new ending is the secret of every penetrating therapeutic result.” 

While there is much good to be experienced through the corrective emotional experience, there is still more to the therapeutic process.  This “more” has to do, in my opinion, with delving into those earlier experiences of hurt, rejection, and misunderstanding.   These experiences from the past continue to exist in a person’s life; often they are in the background and exert a significant influence.  To truly heal from such experiences means not only having new and different experiences to replace them with, but also doing the necessary emotional work – which often involves a process of grief – in the presence of another (in this case the therapist).  In such experiences, it isn’t only the critical things that a parent said or the instances of neglect that injure, it is also what was missing in the experience. If a person grew up with a harsh, authoritarian type of father, there was the absence of more understanding and beneficent father.  If a person lived with an out-of-control mother, there was also the absence of a soothing and comforting mother.  To move through those experiences is to grieve what was both present and missing, what a person deserved that was not there. As is the case with grief, in order to progress, to move through the loss and then resume one’s life, one’s relationships, the process involves experiencing a range of feelings.  And what is key to the healing process is to experience those feelings in the presence of another person. To not be so alone.

Psychotherapy, in my view, provides the opportunity for healing old wounds by offering a different experience than one had in the past and by providing a process to grieve and move beyond those past wounds while accompanied in the journey by another human being.

Alexander, F., French, T. M., et al. (1946). Psychoanalytic Therapy: Principles and Application. New York: Ronald Press.

The Relationship Crucible

There was a wonderful article recently in the New York Times, by a wonderful and favorite writer of mine, Diane Ackerman, that talks about how science has proved what psychotherapy has known for some time now: change takes place through relationship.  Citing the new field of interpersonal neurobiology, Ms. Ackerman, in her piece called “The Brain on Love,” writes about how science has concluded that the brain is constantly changing and regenerating and how it is relationship that particularly changes the brain.  “All relationships change the brain — but most important are the intimate bonds that foster or fail us, altering the delicate circuits that shape memories, emotions and that ultimate souvenir, the self.”

Much time is spent in psychotherapy – at least the way that I practice it – talking about some of those past intimate bonds and how they have shaped one’s brain, psyche, and soul. This examination can sometimes be painful, sometimes ecstatic, depending on those past experiences.  When talking, it’s our objective to better understand how these experiences have shaped the client and to continue to process emotionally the painful and sometimes traumatic experiences.  While we can’t change the past, we can through our relationship lighten the load and influence that the past bears on the present.

And in the process, there is another intimate bond that is formed: that of the client and therapist. Through this bond, new changes in the brain take shape.  It is to a large degree that relationship which promotes change in psychotherapy.  It’s true that insight is a part of that change process; changing behaviors and patterns can be a part of it.  But it is principally through the human bond that is fostered in the psychotherapeutic relationship that changes take root in the mind.

The very first relationship in a person’s life, of course, is the baby with his or her mother. According to Ackerman, “Thanks to advances in neuroimaging, we now have evidence that a baby’s first attachments imprint its brain. The patterns of a lifetime’s behaviors, thoughts, self-regard and choice of sweethearts all begin in this crucible.”  However, there is also evidence that subsequent relationships continue to alter and shape the brain.  “As the most social apes, we inhabit a mirror-world in which every important relationship, whether with spouse, friend or child, shapes the brain, which in turn shapes our relationships.”  Sometimes the goal of psychotherapy is to examine that “mirror world” – to see how one may be responding in the here and now as if to some past experience or relationship.  By seeing this connection, one then has more ability to alter that link and act differently today.

The relationship with the psychotherapist becomes one of those “important relationships.”  The article sites Daniel Shore, a prominent neuropsychiatrist at UCLA, who “refers to the indelible sense of ‘feeling felt’ that we learn as infants and seek in romantic love, a reciprocity that remodels the brain’s architecture and functions.”  That feeling – “feeling felt” – is the feeling in psychotherapy.  It is a feeling comprised of being understood, empathized with, and deeply listened to.  And it changes brains and apparently promotes good health.  “’Scientific studies of longevity, medical and mental health, happiness and even wisdom,’ Dr. Siegel says, ‘point to supportive relationships as the most robust predictor of these positive attributes in our lives across the life span.’”

Much of this wonderful article talks about the impact of a loving and supportive relationship on one’s overall growth and functioning.  Beginning with psychotherapy’s founder, Freud, love has had a lot to do with the therapeutic relationship. It is the degree to which this intimate bond is forged and felt that true change takes place. “A happy marriage relieves stress and makes one feel as safe as an adored baby.”  And I think psychotherapy, when successful and supportive, and I would say loving, does the same thing.

Flip Flopping Towards Health

Much can be known about the American psyche from even a casual glance at American politics.  My focus here is to address the psyche and not the politics of the politicians.  Take what happened yesterday.  A spokesman for the Romney campaign said some things about hitting the “reset button” when the general election campaign begins after the primary season concludes.  Apart from what that meant and people’s reactions justified or not, something of the American psyche was evident in Rick Santorum’s reaction.  Mr. Santorum, in a clip I saw, talked about how his (and I’m paraphrasing) sentiments were rock solid (I do recall him using the word “rock”), thus implying his steadfastness and, given that rocks only change through glacial time, the unchanging quality of his mind.

Which led me to wonder – since when did health get equated with the lack of change?  Why is a healthy mind like a rock?  Not too long ago the concept of “flow” became more prominent. That a healthy mind is one that can change, has flexibility (“elasticity” I believe is the term that neuroscience uses to express the brain’s ability to change).  I had similar thoughts some years ago when Presidential candidate John Kerry’s campaign was sunk by, among other charges, accusations of being a flip flopper.  When did changing one’s mind become evidence of weakness? What became of “openness” and “receptivity” to new ideas. (I suppose the last Presidential election centered on the idea of change.) While it certainly is important to have convictions and the courage to stand for them, why can’t even convictions or principles change as people and the times change?

My clients and I in psychotherapy work with a different view. There is, of course, much to be said for knowing one’s mind, having an opinion and expressing it. And often the work in psychotherapy involves helping the client know what he thinks and feels, what he wants.  And just as often the work is focused on helping the client develop a flexible mind.  With flexibility comes options, and options open up the psychic and emotional terrain. It is a flexible mind that can empathize: that can understand another’s point of view even if quite contrary to one’s own.  It is a flexible mind that grows – that can see oneself and others in a new light and not just according the reflection of the past.

There was a time when, even in politics, to change one’s mind was not a bad thing. Abraham Lincoln changed his position on slavery.  Initially, while being opposed to slavery, he was not an abolitionist.  In 1860 he called for slavery not to expand into any more territories. He did not call for abolishing all slavery until 1864.

In psychotherapy we are in pursuit of developing a kind of ambidextrous mind. In fact, often the problems that bring a person into psychotherapy have to do with what has become rigid, calcified in the mind (one’s idea of oneself, for example, or of others).  We are after the type of mind that can flow, even over rocks and other hard places.

Some More Thoughts About Feelings (Intuition)

Earlier I wrote about the more conventional understanding of feeling: as an emotion that one experiences or perhaps one defends against experiencing.  There are some other ways, however, that we use the term “feeling.”

There is another type of feeling, what is commonly referred to as a kind of knowing in one’s core or “gut.”  “I need to listen to my gut more” is a common refrain that points to this sort of knowing.  This is what we call “intuition.”  That sense or feeling of what is right or wrong.  There is, of course, much to be said for the wisdom of intuition. Often clients whom I work with struggle to be more in touch with this feeling, also referred to as “felt sense.”  Those who do struggle may be more oriented to thought, to intellectualization, and a more rational interaction with life. And intuition for them is not so available.  They may get stuck in reasoning and not have a more emotional footing by which to make decisions and live their lives.

Of course, we usually strive in psychotherapy for balance: in the case of intuition, that gut feeling balanced with the ability of the mind to reason and discern.  Sometimes a person’s gut may say “I don’t want to do that hard work,” “I don’t want to leave the house when feeling depressed.”  Here it’s useful to have the mediation of ones’ mind -- in the parlance of Freud’s model the “ego,” -- one’s thinking capacity to mediate and at times veto that more gut feeling. “I may not feel like going to the gym but I know that I’ll feel better afterwards if I do.”  At other times, however, it might be better to lean in the direction of intuition. Especially when making a major change, which almost always involves a great deal of fear and ambivalence, it may be best to privilege that gut feeling that “this is the right thing for me to do.” Such moments often feel like great risk. And such moments may offer great reward.

Psychotherapy: Two Minds Trusting One Another

I came across the following passage in a journal article.  The author of the article  quotes from Sheldon Bach, Ph.D., a contemporary psychoanalyst:

“Most importantly, since I am implicitly asking my patients to trust me with their minds, I struggle to attain a position where I can trust them with my own mind and feel that I have nothing to hide from them.”

I like that quotation very much.  Psychotherapy, as I understand and practice it, is about the sharing of minds.  It is my job to lend my mind to my client’s; in that way the two of us think together about the issues that cause him or her distress and suffering.  The process, while being squarely focused on the client and on what he or she needs to promote change, is not one directional though.  Our thoughts flow back and forth and relate to one another. Therefore, as Dr. Bach wrote above, I too need to be open to my thoughts and feelings, my mind, being influenced by the dialogue we are creating.  I too need to trust my client with my mind.

The process of sharing one’s mind is extremely intimate, both for the client and for the therapist.  Trust, which can take some time to build (which is another reason why the process can take some time), is essential.  I appreciate Dr. Bach’s perspective: indeed, how can I ask my client to open and share his mind if I am not prepared to do the same?

That brings up the subject of self-disclosure: how much of himself does the therapist reveal?  I strive to be open and judicious about how much of myself to share; it’s paramount to me that the therapy be focused on the client, aimed at helping him, and not on me.  It is true, however, that neither the client nor I have anything to hide; I often say to a client that I invite him or her to say anything and everything that is on his or her mind. Psychotherapy offers this rare opportunity for someone to speak whatever he or she thinks or feels. There are many times when sharing what is on my mind is a key component to the therapy.  While I will decide on what to share, based on my sense of what might be helpful to the client, I also find that maintaining an attitude of openness is essential.  This attitude of openness and trust provides the foundation for the work to unfold.

It is true that I am not so prone to discuss with my clients such personal issues as where I am going on vacation or where I live.  I understand that there are some therapists who do that.  My focus is more on sharing my thoughts, reactions, feelings with my client (again, when it seems that doing so will be helpful). In this process, I believe that my clients get to know me – and how I think – very well. That we get to know one another very well indeed.

Some Thoughts About Feelings

Feelings often occupy the focus in psychotherapy.  Often I will ask my clients how they feel; often they will either speak of or show their feelings, particularly the distressing ones.  I have been thinking about feelings lately and it occurs to me that there are different types – I’m inclined to say species – of feelings.

There is, of course, what one would immediately think of as feelings.  Those states of being that are described as “happy,” “sad,” “frustrated,” “angry,” etc.  Often when talking about those feelings, I ask my clients to find them in their bodies because I believe that feelings are housed in the body.  We may “think” about how we feel; but we know how we feel by feeling the sensations.  If I feel sad, I may become aware of heaviness in my chest, a swelling of tears in my eyes, heartache. If I’m anxious then there are corresponding feelings, a fluttering heartbeat, chills, a feeling of jumping out of my skin.  All of these physical sensations manifest what the feeling is and what it feels like.

Often a goal of psychotherapy is to help the client share, express, emote what he or she is feeling.  Feelings can sometimes feel or be thought of as overwhelming.  In fact, given many people’s earlier experiences of feelings as extremely painful and particularly unempathic responses to those feelings by others (“I’ll give you something to cry about,” “big boys don’t cry”), a central problem often emerges for people about feeling their feelings: The belief that they will be too much, too overwhelming, and generally unwelcomed by others. For those with some history of trauma, feelings were too much.  Thus people learn to disconnect from their feelings, to repress them, or seek behaviors and patterns that help numb those feeling.  A psychotherapeutic relationship, therefore, provides a way to reinstate the process of feeling, learning to tolerate (they are now not as overwhelming or scary as once believed) and express them.

In this way, through the supportive and understanding relationship that we create, the client can explore and move through those feelings that are troubling and distressing.  This process does not occur all at once; but through the sustained practice of expressing feelings – in the context of a relationship, where someone witnesses and participates in that process – the client can learn to tolerate feelings and to move feelings along when one has felt so stuck.

When helping clients to identify and express their feelings, I work with a central principle that feelings “can’t be wrong.”  This doctrine applies in particular when working with couples, where it may be hard for each person to hear and recognize the other’s feelings.  Feelings can’t be wrong.  One may see a situation differently; one may want something different from the other.  However, a central task in couples therapy is helping each person to understand the other’s feelings. And a central task in individual therapy is often to help the client support and accept his or her own feelings. 

I’ll share more thoughts about other types of feelings in the next postings.