In our last blog, entitled ‘The Pyramid of Change’, we introduced the concept (and paradox) that in order to achieve results (change) the locus of attention needs to begin not with change but with the felt sense in the body. How can we facilitate this?
Counsellors and psychotherapists are taught to ask one particular question, in many different guises. It goes kind of like this: ‘And how do you feel about that?’. But, this question is based on a very unrealistic and dangerous assumption: that the client can feel, knows what a feeling really is, and then how to distinguish between feelings.
The ability to feel, requires an attunement with our bodies. The development of a moment to moment sensitivity to our physiology – the orchestra playing in our body – that brings forth our emotions, and enables us to define our feelings.
Most people presenting for counselling or psychotherapy have experienced some sort of relational trauma in childhood, the severity of which correlates to their pathology, or current relationship to self and others. In attachment theory language, they are insecurely attached. And remaining in attachment theory language, the role of therapy is to change that attachment style to one of secure attachment. We re-parent our clients. At least, that’s the idea.
When we assume that a client knows what they are feeling, we assume that there was enough attunement – bodily, psychically, emotionally and mentally – from their primary carer, for this developmental process to have been completed. Sadly, this is very unlikely to have been the case.
The role of culture and gender
In the Western world, ‘feeling’ is not seen as helpful. In fact, most corporate and political structures reward a lack of feeling. Thought is prized above all else, yet few of us stop to think about why we are thinking a certain way.
Add into this generations of subscribing culturally to a patriarchal model that dictates that ‘boys should be strong’ and you have a recipe for disaster when it comes to people working out how they feel. Most men have profound trouble defining a feeling and when they can, the feelings tend to be somewhere in the region of ‘OK’ or ‘shit’, with little in between. Women may generally be slightly better at this than men, but their sensitivity to their emotional state remains curtailed by the mind-body split and social conditioning.
If, as is increasingly being evidenced through research in the fields of neuroscience and neuroendocrinology, results (change) are driven by an attunement to our physiology ,as the first step, and then the regulation of affect (physiology and emotions) through directly influencing our physiology, as the second step, I would suggest that as counsellors and psychotherapists our job is two-fold.
Firstly we are responsible for using our own physiology, emotions, psyche and mind – to help clients understand what they may be sensing in their bodies, how these sensations are travelling (emotions), how clusters of emotions comprise feeling states, how these feeling states influence their thoughts, how their thoughts influence their behaviour and how all of this ultimately contributes to how they experience themselves and others in the world (results).
The second step is to help clients tolerate their uncomfortable feeling states and whilst remaining connected to the here-and-now. This is in part and initially achieved through the relationship in the therapeutic dyad, and subsequently in part through helping clients’ access tools (internal and external) that enable them to regulate their own emotional state (which we have blogged about before).
It is these two steps, that we believe, comprise results driven Functional Psychotherapy and should lie at the core of any treatment plan. To quote Dr Allan Shore, psychotherapy is ‘an affect-communicating and affect-regulating cure’.
And, of course, there is a process preceding steps one and two that clinicians can come to overlook: if we want to be able to offer this to our clients, we need to be able to do it for ourselves. It can’t be learnt from a book, or in expensive training courses. It is the cultivation and development of our own felt sense and emotional landscape. Otherwise we are offering our clients mere insights, at best, which can only lead to short-term behaviour changes. And behaviour changes, as we now know, lead to failure, as long-term change starts in the body and not in the behaviour.
So, to end, I would suggest that we all need to reconsider our intentions in asking our stock question of ‘so how do you feel’ and follow it up with variations on the following:
‘And how do you know you are feeling that?’; ‘What is happening in your body that tells you that?’; Notice that and hang out with it, how is that?’; and ‘What happens next?’.
Image Credit: Brighton and Hove Psychotherapy Copyright
For more information on the Pyramid of Change, click here to download our guide.