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Tuesday, February 6, 2018

Taking Risks in Your Therapy

Many clients who are in therapy avoid expressing their reservations or negative feelings about therapy or their therapists.  Some clients, who were discouraged from expressing their feelings when they were children, continue the same pattern without even realizing it in their relationships and in their therapy as adults (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).  Deep down, they don't feel entitled to their feelings.  Other clients are afraid that they will offend or alienate their psychotherapist by expressing negative feelings.  But in order for the therapy to be alive, meaningful and valuable for clients, they need to take risks in their therapy because, if not, these unexpressed feelings contaminate the therapy and have a negative impact on the relationship between the client and the therapist (see my articles: Why Being Honest With Your Therapist is the Best Policy and How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Taking Risks in Your Therapy 

A Childhood History of Feeling Invisible and Undeserving
Clients who grew up in a family where they were discouraged and, possibly, even punished for expressing their feelings learn quickly to keep their feelings to themselves.  Over time, they also learn not even feel their feelings, so they are unaware of their feelings on a conscious level.

This pattern is often carried over when they become adults in their personal relationships and relationship with their psychotherapist without their even realizing it.

Therapists who recognize this pattern in clients need to provide a safe therapeutic environment (see my article: The Creation of a "Holding Environment in Psychotherapy).

Psychotherapists also need to help these clients to identify their feelings so they can express them.  Many clients, who are having the experience for the first time of expressing negative feelings might begin by having big reactions that frighten them once they begin expressing their feelings, so the therapist also needs to help these clients to manage their emotions.

Learning to express negative feelings after a lifetime of bottling them up can be challenging, so clients need to learn to respond instead of react when expressing themselves (see my article: Responding Instead of Reacting).

A Fictional Clinical Vignette: Taking Risks in Therapy
The following fictional vignette illustrates the points that I've made above and how psychotherapy can help:

Beth
Beth, who was in her early 30s, began therapy because she thought she was being taken advantage of in her two year relationship.

She told her new psychotherapist that her boyfriend, Alex, would often assume that when they went out that Beth would pay because she made more money that he did.  She said that, although she didn't mind paying sometimes, she didn't want to pay for their dinner, movies and theater tickets all the time.  She especially didn't want Alex to assume that she would always pay, which he did.  She felt that, although he made less money than she did, he made enough money to offer to pay sometimes.

Taking Risks in Your Therapy
Beth also mentioned other issues in the relationship where she felt taken advantage of.  When her psychotherapist asked Beth if she ever discussed this with Alex, Beth gave her a blank stare and then she gave all her reasons why she had not spoken to Alex about these issues, "It wouldn't make a difference anyway," "He's just like that--he won't change" and so on.

Eventually, over time, Beth came to see these "reasons" as rationalizations and excuses for her passivity.  But, at this point in her therapy, she believed her rationalizations.

It turned out that Beth had so much bottled up resentment towards Alex over the two years that they were in a relationship that she no longer wanted to be sexual with him.  But, until she came to therapy, she never made the connection between her unexpressed anger and resentment and her lack of interest in having sex with Alex.

When Beth thought about it, she said she had always been a sexual person, and she had been very sexually attracted to Alex during their first year together.

Before discussing this in therapy, she just thought that the decrease in her sexual interest was a normal part of being in a two year relationship. But now she sensed how her resentment and anger contributed to the cooling off of her feelings for Alex.

When her new psychotherapist asked Beth if she had ever been in therapy before, Beth told her that she had been in therapy with several different therapists over the last few years, but she left each of her therapists when they said or did something that she didn't like.

When her therapist asked her if she ever spoke to any of her therapists about her misgivings, Beth realized that she never did--she just left abruptly (see my article: When Clients Leave Psychotherapy Prematurely).

Beth described her parents as being emotionally distant and preoccupied with their careers.  As an only child, Beth spent much of her time alone.  She never saw her parents argue, but she also never saw them being affectionate with each other.

She remembered times when she tried to tell her mother about feeling lonely at home and at school, but her mother never wanted to hear it.

Her mother especially didn't want to hear any complaints from Beth about anything going on at home or about Beth feeling angry towards her parents.  So, eventually, Beth learned to keep her feelings to herself, and she approached her romantic relationships in the same way.

Beth's therapist helped Beth to feel comfortable in therapy and encouraged Beth to tell her if she had any misgivings about the therapy or her therapist.  She told Beth that she wanted her to be able to talk about any problems in therapy rather than Beth just disappearing from therapy as she did in her prior therapies.

As Beth continued to attend her therapy sessions, she got more comfortable with her therapist.  At one point, when Beth felt misunderstood by her therapist, Beth broached this topic with trepidation.  Beth felt that her therapist didn't understand what she was trying to say, so she got up her courage to tell her therapist.

But when she began to talk about it, she felt such uncontrollable rage welling up inside her that she couldn't get the words out.  She felt unable to breathe, her heart was pounding, and it was as if the words were stuck in her throat.

Her therapist helped Beth to calm down enough so she could breathe and feel grounded.  Then, even though she still had difficulty, Beth was able to speak clearly and articulate her feelings.

Taking Risks in Your Therapy

With the help of her psychotherapist, she also made connections between her family history of feeling  invisible and undeserving and how this affected her adult relationships.

Over time, Beth gradually became more comfortable taking risks in her therapy. She was able to speak up when she felt misunderstood or something occurred that she didn't like.  Unlike her childhood experiences with her parents, Beth saw that her therapist was open to talking about any problems in therapy and there were no negative repercussions.

Similarly, when Beth felt there was a rupture with her therapist, after she talked about it with her therapist, she also saw that these ruptures could be repaired (see my article: Ruptures and Repairs in Psychotherapy).

This helped Beth to feel more confident in other areas in her life, including her relationship with Alex.  As a result, she was able to talk to him about the areas in their relationship where she had misgivings, which helped to clear the air and also helped them to make positive changes in their relationship.

Conclusion
When clients have problems expressing negative feelings about aspects of their therapy or about their psychotherapist, there is usually a long history of this problem that goes back to childhood.

For these clients, in the short term, it's easier to leave therapy abruptly than take the risk of expressing their feelings and dealing with their fear of rejection or some form of retaliation by the therapist.  This usually results in a string of aborted therapies over time which, in the long run, is usually damaging to the client.

By the same token, these same clients often tolerate inappropriate behavior in their relationships, similar to Beth in the fictional vignette above.  Their anger and resentment have the same effect--they either leave the relationship or the relationship slowly dies because the relationship becomes buried in these unexpressed negative feelings.

If clients, who are reticent about expressing negative feelings, can learn to express these types of feeling in therapy, they can use this skill in their relationships.

At first, it might feel uncomfortable but, over time, clients can become more comfortable expressing themselves, which leads a greater sense of authenticity as well as more authentic relationships.

Getting Help in Therapy
The unspoken and, possibly unconscious, fear that it's dangerous to express negative feelings is very hard to overcome on your own because it's usually so ingrained.

A skilled psychotherapist can help you to recognize and express uncomfortable feelings in an effective way.  She can help you to develop the necessary tools so that you don't feel overwhelmed by your own feelings (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

She can also help you express yourself in an effective way--without your minimizing your feelings or overreacting in ways that would be overwhelming to you or to others and make your communication ineffective.

Rather than struggling on your own, you could benefit from getting help in psychotherapy so that you will eventually feel more comfortable and confident in yourself.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to take risk in therapy so that they can lead more fulfilling and authentic lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.
















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