As therapists, sometimes it can be easy to rush the process. But occasionally a bigger truth emerges as we take the time to ask our clients more questions and notice more of the details. After all, one little piece of the puzzle does not reveal the whole picture.
As a therapist, people often enter my office with an idea of what’s “wrong” with themselves or a family member. It’s our job to get curious, ask questions, and determine if they are accurate in their assessment or if a pattern has emerged as a result of trying to avoid painful emotions, discussions, or truths. That’s why it’s important to ask ourselves, Are our client’s presenting concerns a result of something underlying, or because of their efforts to adapt to an unpredictable or unpleasant emotion?
It’s our job to get curious, ask questions, and determine if they are accurate in their assessment or if a pattern has emerged as a result of trying to avoid painful emotions.
To give you an example, as I was tending my garden earlier this summer, I turned the wrong way and felt a very painful “tweak” in my left knee. In the coming days, I found myself adjusting how I walked and moved to avoid the slightest twinge of pain. Although I was satisfied that I had taken such good care of my knee, other pain and discomfort started to show up in my feet and legs. I consulted Dr. Google and started to diagnose myself with a variety of ailments. Each day I became more fearful that I had a chronic condition (or two . . . or three!).
I finally decided to consult my physiotherapist. He listened sympathetically as I described my symptoms. But when I proposed my own diagnosis, he didn’t confirm it. Instead, he asked me to perform a series of tasks while he observed and asked questions. And then he invited me to do some stretches and see if there was any relief to my symptoms. Amazingly, there was!
He explained that my efforts to prevent more pain led to a repeated pattern of movements that caused the subsequent symptoms of discomfort and immobility. And then he said, “You don’t have to be afraid of pain. And most importantly, keep moving.”
I was very appreciative of his wise counsel. And the profound simplicity and truth of what he said struck me as I was walking my dogs a few days later. And then I thought, How does this apply to my therapy work?
Most of us have learned to avoid discomfort, so we may engage in all sort of compensatory behaviours to prevent the next painful experience.
Most of us have learned to avoid discomfort, so we may engage in all sort of compensatory behaviours to prevent the next painful experience. However, in therapy we often invite our clients to face difficult emotions, revisit painful experiences, and confront difficult relationships in order to set boundaries.
How can we, as therapists, prepare our clients to face their pain?
The main way we can do for our clients is to slow down enough to notice what’s actually going on. If my physiotherapist had simply taken my word for what I thought was wrong, he may have approached my treatment differently. But he took the time to observe and ask more questions, and very quickly determined that I had changed the way I normally moved in an effort to avoid pain, causing other muscles to tighten.
This is similar to what happens in our efforts to avoid psychological and emotional pain. Often, a new pattern emerges but with drawbacks: less intimacy in relationships, decreased ability to express a range of emotions, and, at times, worry and dread about future painful situations.
In therapy, the process may take longer, but sometimes we also reach a similar conclusion. Often a client will have a painful experience and change their behaviour to avoid having another painful experience. But the discomfort that accompanies pain is meant to be a temporary state.
What does it mean to keep our clients moving psychologically and emotionally?
We can coach them to not fear or avoid painful emotions. It’s often an opportunity for growth when we are able to be present to our feelings. Some of the most profound experiences we have often occur during times of grief and loss, serving as a reminder of our capability for love and resilience.
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