{"id":87,"date":"2014-04-15T22:22:33","date_gmt":"2014-04-15T22:22:33","guid":{"rendered":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/?p=87"},"modified":"2014-04-15T22:22:33","modified_gmt":"2014-04-15T22:22:33","slug":"empathy-and-the-basics-yet-again","status":"publish","type":"post","link":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/empathy-and-the-basics-yet-again\/","title":{"rendered":"empathy and the basics yet again"},"content":{"rendered":"

I’ve written a few times about the dangers of thinking you know what’s wrong with you; see this entry<\/a>, also this one<\/a> and this one<\/a> from the main website. \u00a0Here’s a fun moment from a session which shows how this very common assumption that you know what’s wrong with you can mess up your life, blinding you to what\u2019s right in front of your face.<\/p>\n

Terry had been seeing me for a couple of years when he came in one day saying that he had been feeling more relaxed in recent months, was not so inhibited around other people, was quarreling less with his wife, and had been able to get out and enjoy his financial successes without such obsessing and worry.\u00a0 But, he continued, for the past couple of weeks he had not been sleeping well and in particular he seemed to be developing restless leg syndrome despite his young age.\u00a0 As he described all this and began to tell me about a recent experience with his wife, I found myself getting very sleepy and at the same time agitated.\u00a0 As he started talking about feeling like he wants to “jump out of my skin” during some recent disagreements with his wife I realized that that was what I was feeling as I listened to him.<\/p>\n

At this point I interrupted to ask about some details of these arguments and, just as the textbooks would predict, it turns out that there was a lot more agitation and anger lurking under his presentation.\u00a0 He described in more detail what went on between him and his wife and became clear that, for all of his efforts to be accommodating his wife was being quite impatient with him.<\/p>\n

Add to this what I had learned about Terry during our work together.\u00a0 He always presented with timidity, almost exaggerated deference, and with the complaint of being scared.\u00a0 He focused particularly over the years on his fear of being fired or disciplined at work.\u00a0 Yet upon inquiry it always became clear that not only was he in no danger of being fired or disciplined, not only did he receive regular bonuses, verbal praise, referrals for more and more complex work, but in fact he never even behaved at work as if he was so afraid.\u00a0 Whenever I dug into the stories he told me, it was clear that he was quite assertive on the job, set limits when needed, and even snapped at people on occasion.\u00a0 So we already have a history of him presenting himself to me \u2013 and to himself \u2013 as tiptoeing on egg shells, as oh so fearful of being at all assertive, yet underneath quite able to identify when he is being pushed around and to become appropriately angry about it.\u00a0 Well, that anger at his wife wasn’t so easy to vent and it was keeping him up at night.<\/p>\n

As soon as this anger began to emerge in our discussion, Terry lapsed into that refrain of denial that is so common in psychotherapy.\u00a0 He started to object “I know she’s being irrational and her impatience is unreasonable.\u00a0 She’s always like that when she\u2019s stressed.\u00a0\u00a0 I’m used to it.”\u00a0 As we talked, however, he noticed that he felt looser, clearer, and freer as we spoke, as well as angrier about his wife’s recent behavior.\u00a0 He suddenly “remembered” her reaction in the middle of the night when his restlessness awakened them both.\u00a0 He apologized and moved to the sofa; his wife was irritated, complaining, even accusing.\u00a0 Expressing some surprise he said “I never noticed it, but she never asks me what’s wrong, never shows any kind of sympathy.\u00a0 Wow\u201d he added, \u201cThat stinks!\u201d \u00a0Suddenly he sat up and acknowledged just how pissed off he was.<\/p>\n

By the end of the session, Terry felt much better, his speech was not so monotonous, he was looking forward to dinner with his wife, the weekend activities with some friends, and even work.\u00a0 All of this is in contrast with his tense demeanor and monotonous speech at the start of the session even though the content of his words were at first how things were in general improving.\u00a0 Moreover, he came in two weeks later and described a new and sustained good mood since that session \u2013 shutting down petty objections at work without so much second guessing and worrying, giving himself little pleasures instead of his usual pattern of staying home and fussing, and overall feeling \u201clighter\u201d.<\/p>\n

And as the fringe benefit to me, all of my sleepiness and agitation during the session evaporated as well.\u00a0 This is always fun in psychotherapy and the phenomenon is called empathy<\/em>.\u00a0 A patient tells a story but is not connected to the affect of it.\u00a0 If patient and therapist are well-connected, the therapist may experience the feelings that the patient is avoiding.\u00a0 I’ve had sessions where I\u2019ll be listening to a patient and despite the surface calm of the moment find myself enraged, deeply depressed and empty, giddy, hostile and snippy, silly, deeply afraid, and much more.\u00a0 If the session is successful, and if of course the patient is ready for this kind of work, the therapist can return those feelings to their source \u2013 to the patient.\u00a0 The result is that both of us feel better and the patient is functioning better.<\/p>\n

One last thought.\u00a0 People ask me sometimes “how can you listen to people’s problems all day?”\u00a0 These moments of empathy are part of what make it fun, rewarding, even exciting.\u00a0 Don’t forget, Terry told a fairly mild story.\u00a0 I have moments of empathy with patients describing much more horrific experiences, struggling with much more intense and unwieldy emotion.\u00a0 It can be quite a ride.<\/p>\n","protected":false},"excerpt":{"rendered":"

I’ve written a few times about the dangers of thinking you know what’s wrong with you; see this entry, also this one and this one from the main website. \u00a0Here’s a fun moment from a session which shows how this … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/87"}],"collection":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/comments?post=87"}],"version-history":[{"count":2,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/87\/revisions"}],"predecessor-version":[{"id":89,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/posts\/87\/revisions\/89"}],"wp:attachment":[{"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/media?parent=87"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/categories?post=87"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.aboutpsychotherapy.com\/aboutpsych-blog\/wp-json\/wp\/v2\/tags?post=87"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}