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Wednesday, March 13, 2013

The Psychotherapist's Empathic Attunement to Unconscious Communication in the Therapy Session

Traditionally, psychotherapy, often called "talk therapy" relies on words that are spoken by the client and the therapist during a therapy session.  But there are times, especially when there is a strong sense of empathic attunement between the therapist and client, when feelings are unspoken and communicated without words.  Feelings can be communicated unconsciously.

The Psychotherapist's Empathic Attunement in the Therapy Session

Sensing Unconscious Communication
A therapist, who has a good rapport with a client, can often pick up on a client's unconscious communication during a therapy session.  It often goes the other way too, where the client picks up on what is unconsciously being communicated by the therapist.

In fact, at various times, we all pick up on what is unconscious and unspoken in our daily lives, especially with people who are close to us.  Sometimes, we're more aware of it than others.

The Psychotherapy Session as a Unique Time and Place For Unconscious Communication
The psychotherapy session is a unique place where a special time is designated on a weekly basis for the therapist and the client to meet to focus on the client's emotional needs.  There are no interruptions or distractions, so this creates an especially good environment for the therapist to pick up on unconscious communication if she works with unconscious process.

There are times when a therapist might ask about what she senses with the client on an unconscious level because she thinks it would help their work together.  Then, there are other times when she might not because it would be premature and would not serve their work.

As a therapist, I find that it's usually best to ask the client rather than to tell him or her what I might be sensing on the unconscious level for several reasons:
  • First, I could be completely wrong in what I think I'm sensing.  
  • Second, I might be correct, but the client might not be ready to talk about it.  
  • Third, by being somewhat tentative in discussing possible unconscious communication, it allows clients the freedom to reflect on it in their own way rather than imposing my view.
Often, if the therapist is emotionally attuned and the timing is right, talking about what is being unconsciously communicated by the client can open up new areas to be explored in the therapy.

An Example of the Therapist's Empathic Attunement to Unconscious Communication in the Therapy Session
It's not unusual for clients to experience feelings of abandonment when their therapist plans to be away.   For many clients, these feelings are unconscious, so they're not aware of it.

Some clients, especially if they had to think and act like adults when they were children, are very good at hiding these feelings.  They had a lot of practice as children pretending that they were okay when they really weren't.  Many clients even convinced themselves as children that they were really okay when they really weren't.  So, pretending to be okay to themselves as well as others when they're not comes naturally to them.  They don't even need to think about it.

If the therapist is attuned to a client and also knows the client's history, the therapist can often sense the client's unconscious feelings of abandonment before the therapist goes away.  It's important for the therapist to be as tactful as possible, especially if the client prided himself on being able to take care of himself when he was a child.  Feeling emotionally vulnerable might feel threatening to the client.

If the therapist doesn't use tact and good timing, the client might feel ashamed of his feelings, as he might have when he was a child and he was expected to be more mature for his age and psychological development at the time.

But if the therapist is tactful and helps the client to understand that many clients experience similar feelings, especially if they had childhood trauma where they were abandoned emotionally, then it can be a relief to the client, and discussing what has been communicated unconsciously becomes meaningful to him.

How Does a Therapist Sense the Client's Unconscious Communication?
Not all therapists work with the unconscious.  For instance, a therapist who is strictly a cognitive behavioral therapist often will not, although I think this is changing somewhat.  But assuming that the therapist values the unconscious and works with it, she has different ways that she might sense unconscious communication from the client.

Since I place a lot of importance on empathy in treatment, I often sense physically or emotionally what the client is feeling.  It's often a visceral feeling for me.  Other times, it's a thought.  Or, I might find a particular song playing in my mind and the words or tune become relevant to what's happening with the client.  A picture might flash in my mind's eye that seems to be relevant to my interaction with the client during his or her session.  Then, it 's a matter of whether or not to communicate it to the client and, if so, how.

The Therapist's Attunement Can Be Emotionally Reparative For the Client
For many clients, the therapist's attunement can be an emotionally reparative experience, especially if the adults in their lives weren't emotionally attuned to them when they were children.

As previously mentioned, therapists make mistakes at times.  When a therapist makes a mistake with regard to emotional attunement, it's important for the therapist to acknowledge this to the client (see Link below for a prior blog article called "Psychotherapy: Ruptures and Repairs in Treatment").

Emotional attunement to unconscious process in therapy is a vast topic.  I hope this blog post begins to, at least, introduce the topic.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

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.

Also, see:  Psychotherapy: Ruptures and Repairs in Treatment

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