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Saturday, September 15, 2018

Experiential Psychotherapy: Overcoming the Secondary Emotion of Shame to Get to Core Issues

Shame is a secondary emotion when it masks deeper, underlying primary emotions (see my article: Healing Shame in Psychotherapy).  In this article, I'm focusing on how experiential therapy helps to get beyond secondary emotions, like shame, to work on primary emotions and core issues (see my article: Experiential Psychotherapy: Learning to Experience and Communicate About Your More Vulnerable Emotions).

Experiential Psychotherapy: Overcoming the Secondary Emotion of Shame to Get to Core Issues

Since making personal changes involves accessing vulnerable emotions (primary emotions) and communicating from this innermost place, avoiding these emotions is a significant obstacle to change (in this article, I will be using the terms: primary emotions, innermost emotions, vulnerable emotions and similar terms, interchangeably.  All of these terms refer to the same phenomenon).

Whether someone is in individual psychotherapy or in couple therapy, a skilled experiential psychotherapist can help the client to access and communicate from his or her primary emotions.

Experiential therapy is more effective than talk therapy for accessing underlying emotions.  Whether the experiential therapy is EMDR Therapy (Eye Movement Desensitization and Reprocessing, Somatic Experiencing, clinical hypnosis (also known as hypnotherapy), AEDP (Accelerated Experiential Dynamic Psychotherapy) or EFT  (Emotionally Focused Therapy) for couples, each of these therapies emphasizes the importance of the mind-body connection, which allows access to primary emotions (see my article: Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma).

Fictional Clinical Vignette: Experiential Psychotherapy - Overcoming the Secondary Emotion of Shame to Get to Core Issues
The following fictional clinical vignette, which is similar to many psychotherapy cases, illustrates how experiential therapy helps to get beyond secondary emotions, like shame, to access primary emotions, like sadness and hurt:

After several years of attending regular talk therapy, Tom decided to work with an experiential psychotherapist who used a mind-body oriented approach to therapy.  Although he felt he understood his problems better based on the talk therapy that he did, he continued to have the same problems in his relationship and he was no closer to resolving these issues--even though he understood them better (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

Tom explained to his new experiential therapist that his wife often complained that he shut down emotionally whenever she wanted to talk to him about their relationship.  She told him that she was feeling increasingly frustrated that she couldn't talk to him and, as a result, she was feeling lonely in their relationship.  Rather than start with couple therapy, Tom's wife asked him to get help first in individual therapy to address this problem.

Tom acknowledged that this was not the first time that he had been told that he tends to shut down when relationship issues arise.  In fact, he said, two prior girlfriends told him the same thing, and his inability to remain emotionally present during these type of discussions led to the demise of those prior relationships.  Tom said he didn't want this problem to ruin his marriage, so he agreed to seek help in individual therapy.

When his new therapist asked Tom to recall a recent incident where his wife wanted to talk about their relationship and Tom avoided the conversation, Tom said that this occurred a few days ago.

His therapist asked him to go back into that memory and recall what he was experiencing physically and emotionally at the time.  After a few tries, Tom said, "I just can't do it.  It's too uncomfortable."

His therapist explained that, in order to address his problem, it would be necessary to revisit the experience in a visceral way.  She suggested that they could titrate the work into manageable pieces so that Tom wouldn't get overwhelmed.  

Specifically, she suggested that when Tom recalled the memory that he begin to sense into what he felt in his body and if he began to feel overwhelmed, he could take a break.  At first, Tom hesitated, but then he realized that he would rather experience some discomfort in therapy than continue having this problem and risk his marriage.  

So, Tom began again by recalling that he was sitting on the couch in the living room when his wife entered the room.  He remembered seeing a worried look on her face and when he saw this, his stomach muscles began to clinch.  He also remembered feeling queasy and thinking, "Uh-ho, this isn't going to be good."

At that point, Tom told the therapist that he needed to take a break from this memory because he was feeling queasy in the therapy session.  She agreed, so he opened his eyes and he felt better when he saw the look of compassion on his therapist's face.  He realized that his therapist was attuned to what he was experiencing and he wasn't alone in his experience.

When his queasiness subsided, Tom re-entered memory to recall what happened next.  He remembered that his wife came to sit next to him and she placed her hand on his arm saying, "We need to talk about our relationship."

Tom remembered, at that point, he felt physically numb all over his body.  At the same time, his heart was pounding in his chest, and he felt like he wanted to run out of the room.  He remembered thinking to himself, "She's onto me!  She realizes that I'm a failure as a husband and as a man and she wants to leave me!  What will I do if she leaves me?"

He remembered trying to stay calm--even though he wanted to bolt from the room.  At the same time, he told his wife that he was "tired" and he wasn't up to having this discussion.  But when he saw the look of disappointment on his wife's face, he knew he couldn't stay in the room anymore, and he got up abruptly and went for a walk.

As he was leaving the apartment, he remembered hearing his wife saying in a hurt tone, "We need to talk.  You never want to talk about our relationship."

When he returned a few hours later, Tom recalled that his wife was already asleep in their bedroom.  He didn't want to wake her, so he took his pillow and a blanket into the living room and laid down for a few sleepless hours, tossing and turning, before he finally fell asleep as the sun was coming up.

At the end of the session, his therapist asked Tom what it was like to re-experience these emotions in her presence.  Tom thought about it for a few seconds and he said that it wasn't as bad as he anticipated.  He said he appreciated being able to titrate the work and take a break when he felt overwhelmed. He said it gave him a sense of control and that working this way felt more manageable to him.  He told her that he also appreciated her empathy, which made the work bearable.

When Tom came for his next therapy session, his therapist recommended that they go back to the same memory they had been working on the last time.  She told Tom that, in order to get to the core issues, they would slow everything down as if they were watching a movie frame by frame.

Having already had a session where he was asked to re-experience his memory, Tom didn't feel nearly as hesitant as he did the first time.  So, he re-entered the memory and, as his therapist recommended, he slowed everything down.

By slowing down the process, Tom had greater access to physical sensations and emotions that he didn't notice when he recalled the memory during the prior therapy session.  Specifically, he recalled that when his wife said that they needed to talk about their relationship, aside from the queasiness, numbing, and the "uh-ho" feeling, his hands became sweaty and he experienced a lightheadedness.

His therapist recommended that they use a clinical hypnosis technique called the Affect Bridge to go back to the earliest time when Tom recalled feeling this way.  She said this would help them to understand what was getting triggered in him.  She helped Tom to do the Affect Bridge by telling him to sense into the physical sensations, where he felt them in his body and go back to the earliest time in his life when he felt this way.

At first, Tom said nothing was coming up for him, but his therapist encouraged him to take all the time he needed to go back to the earliest time.  So, Tom went back into the physical sensations associated with the memory, and he was surprised with what he came up with.

"This doesn't make any sense," Tom told his therapist when he opened his eyes again, "I don't see the connection between the experience with my wife and what came up with me just now.  There must be some mistake."

His therapist explained that sometimes earlier memories come up that appear to be unrelated to the current situation, but there are usually emotions that connect the experience from the past with the experience from the present.  Then, she encouraged Tom to talk about what came up for him during the Affect Bridge.

Tom thought about it for a few seconds, shrugged his shoulders and then proceeded to talk about the memory that came up, "What came up for me was a memory of being in the third grade and standing up on the auditorium stage during a class play.  I had the lead role in the play and, prior to the performance, I had my lines down pat and I felt good about it.  But when I was on stage that day, I looked down and saw my father's stern face and everything went out of my head.  I couldn't remember a single word.  My teacher had to prompt me throughout the whole play.  I was so ashamed, but when I looked down into the audience after the play was over, I realized that my father had disappeared.  When I got home, my father was sitting in his favorite chair reading the newspaper.  I hoped to creep up to my room without my father seeing me.  But, from behind his newspaper, he said to me, 'You were terrible today.  You really made me feel ashamed and disappointed to be your father.  You're never going to amount to anything.'"

Then, Tom broke down and cried in his therapy session, "All I ever wanted to do was please my father, but he kept telling me how ashamed and disappointed in me he was--no matter what I did.  I felt like such a loser."

When Tom felt calmer, he told his therapist that he could feel the connection between the incident with his wife and the memory he had about his father.  In both experiences, he saw their disappointment and he felt tremendous shame (see my article: Understanding Why You're Affected By Trauma From a Long Time Ago).

In subsequent therapy sessions, Tom's therapist helped him to sense beyond his shame into his innermost, primary emotions.

Initially, it was difficult for Tom to go to his more vulnerable emotions, which turned out to be sadness and hurt.  His therapist explained to him that his difficulty was understandable since he spent most of his life trying to avoid these emotions.  She also explained that if they were going to work through his issues of emotional distancing with his wife, they needed to be able to go there.  However, she worked at a pace in therapy that felt safe for Tom.

Tom continued in individual therapy and he and his wife also began Emotionally Focused Therapy (EFT) for couples.  As he got more comfortable with his vulnerable emotions, he was able to communicate, based on these emotions, in a deeper, more genuine way with his wife.  This allowed his wife to open up too in couple therapy, and they began to strengthen their emotional connection.

Secondary emotions, like anger and shame, defensively mask primary emotions, like sadness and hurt.  This is usually an unconscious process and part of an emotional survival strategy that developed early in life.

Although emotional survival strategies usually help to keep a person from feeling overwhelmed, especially as a child, these same strategies get in the way for an adult.

Talk therapy can help you to develop insight into your problem, but when it comes to issues related to trauma, it often doesn't resolve the issue because it's a "top down" therapy (see my article: What's the Difference Between "Top Down" and "Bottom Up" Approaches to Therapy?).

Experiential therapy is a "bottom up" therapy which, among other things, allows clients to use the mind-body connection to get to deeper issues that are being masked by secondary emotions.  

Getting Help in Experiential Therapy
As I mentioned previously, there are numerous types of experiential therapy for individuals and couples, including EMDR, Somatic Experiencing, AEDP, clinical hypnosis and Emotionally Focused Therapy (EFT) for couples.

All of these experiential therapies use a bottom-up approach that usually gets to the root of the problem faster than regular talk therapy, which can remain an intellectualized experience.

If you're struggling with unresolved problems, you owe it to yourself to work with an experiential therapist who can help you to get to the core issues that are creating obstacles for you (see my article: How to Choose a Psychotherapist).

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

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 (917) 742-2624 during business hours or email me.