That’s a really excellent question because often, when we feel in some way victimized, it is always valuable to explore how our vulnerabilities may have put us at risk or perpetuated damage to self. However, timing can be everything as well as other factors. I’m thinking of a client who was enraged with her husband for having an affair and leaving the marriage. This woman had a fragile and undeveloped sense of self. She had been victimized as a child and had no parental protection or reinforcement for her feelings. This is the early trauma that needs to be repaired by helping her to recognize and value all of what she feels.

Her husband never showed a willingness to work on their marriage, from her perspective. Once she could own and process what she felt towards him, (intense rage and complex feelings), she was then able to recognize, with guidance, her internalization of her feelings and compliance throughout her marriage. At that point she could see her part in the marital disaster (versus externalization). There was a reality that she had been a victim of his deceit and unwillingness to address their marital issues and also a reality that she had dismissed her concerns, fears and feelings for years.

If I’d started out with a focus on the defense of externalization, it could reinforce her shame. I also don’t think it would have been attuned to her enormous anxiety in the present moment, which was triggered by both shame and fear in exposing the powerful feelings that were activated within her and were related to early trauma. Once she could process some of her rage, her anxiety and shame lessened and a space was opened for further exploration.

Each case is so different, and if someone is projecting their will and externalizing their problem…“He made me marry him”… or “I had to take my boss’s abuse,” I would address these defenses first in a very compassionate, shame-sensitive way. (“So it felt like you had no power to choose? Somewhere along the line you learned to disconnect from your feelings, which would have given you more power to chart the course of your life”). But I would also then explore her feelings towards her husband or boss, whether he was in reality abusive or not. So in some cases, I would first address externalization first by raising awareness that she had more power and ability to express herself and make healthy choices inside her than she recognized, but then also open a path to explore her rage and complex feelings. The decision rests on what course is most likely to empower the individual in the moment.

2) A therapist asks, “When you said you normalize rage impulses in a context for the client (why and how any of us would feel it and the price for), can you give a concrete example of what you explicitly might say to normalize rage?”

“It’s so normal that you would feel this intense rage towards your husband for betraying you. Anyone would feel this way.” If we take the example of the client above, I might even say I would feel this way too if this happened to me and/or emphasize the magnitude of the injury (this man was not only having an affair but said he wanted out of their marriage for years and didn’t say anything.) I may also point out that rage is a protest. We are wired to protest when we are abandoned/injured in our important relationships.

3) A therapist asked, “How can I help a client who is not able to describe his body sensations in session. His anxiety is in his striated muscles (no collapsing or confusion), but he cannot name what he is sensing. I am not able to reach his feelings, and he feels incompetent not being able to give me an answer when I ask. Also, this client expresses fear of losing control if he goes into his body sensations.”

It seems like this question has 2 parts:

A) The client is having a shame response (“I’m incompetent/I can’t give you the answer you want”). You mention that you cannot reach his feelings. It seems he may be having the experience that you want something from him (projection of will). Remember we are not trying to reach the client’s feelings. The client usually develops a desire to reach his feelings b/c we help him to recognize that this will take him towards what he wants from therapy. What does he want from therapy? Is he clear about how focusing on his feelings and sensations will get him towards what he wants? Is he clear that you don’t want anything from him/he is not doing this for you/you don’t have any expectations/you don’t need to reach his feelings…? With him, picking up on what you said about a shame response, I would first be sure that he WANTS to learn to pay attention to his body. Does this make sense for him to work in this way?

If it’s something he wants to be able to do, accepting for now that the recommended approach can be healing for him, then we can say “Of course you are not familiar with paying attention to bodily signals. Most people are not. It takes a certain practice, which I am happy to help you with, if you want? (Space for response). If he can notice muscle tension, good! If he notices no sensations, then we’d begin to work with detachment. (Gosh, you’re describing such a horrific experience and you do not feel anything inside as you describe this. I wonder where your feelings have gone? Has it always been like this? So somehow you learned to disconnect from your emotions. How do you feel about this, as we look at how your emotions have been left behind?” “How do you imagine this disconnection from your feelings has affected your life?” Here we are working on transfer of compassion for self and mobilization of will. So this therapist is right about not going further towards feelings before defenses are lowered.

B) There is a fear that if he “goes to his body” he will loose control. Is there a reason he is concerned about losing control (is there a history of impulse control issues)? If not, then this is a thought he is having/this is a place his mind goes (and maybe for good reason, maybe his parents lost control). I would normalize this fear, and I might tell him that in my experience people are more likely to lose control when they don’t attend to their feelings than when they do. People who loose control say, “I don’t know what happened, I just saw red etc.” This is completely different than the mindful tracking of an emotional experience.