Speaking with Susan

A therapist is concerned about being judgmental of a client’s abusive boyfriend.

Susan’s response: When you speak of being judgmental towards her abusive boyfriend, I can empathize with how hard it can be to walk the line between showing our caring and concern without inserting our own will, even subtly, especially when it comes to abuse. I’ve definitely grappled with that dilemma myself.

With someone like your client, there is usually an unconscious invitation to rescue or to take on the person’s rage (i.e. projective identification) so she doesn’t have to face her own conflict. This invitation can be very compelling when abuse is involved. It’s taken experiences like yours to cause me to make a real internal shift so I can step outside the projection. A question like “I see this is very painful for you. I wonder what you hope for when you tell me about this abuse?” helps her to clarify her own desires and vision for her life. If she expresses any desire to free herself, then there is a budding alliance to begin exploring her feelings towards him. We can then anticipate that anxiety and shame will follow because her sense of self has never truly developed. This emergence of these inhibitory affects will give her an opportunity to see what has stood in the way of her own healthy self-protective impulses and feelings. I’ve learned the hard way to be very careful about not preempting her feelings with my own, even though I would likely feel very much as you do. But I don’t want my own feelings to dwarf hers. Her signals to her own unconscious are so in need of strengthening that I don’t want to distract her with my own.

Your insightful comment about possibly conveying your own judgment about the boyfriend is probably true: “I can’t help but think she’ll feel pressure to have to give him up and she’s not ready to do that.” It seems like a good idea to bring this up directly and check it out with her. Like “I’m wondering how you imagine I’m reacting to what you’ve shared about your relationship?” You can always clarify that you of course desire that she be safe while at the same time having no need or requirement for her to do anything. In other words, your acceptance of her remains the same regardless of her choices and you are very respectful of her right to make her own decisions.

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From the DEFT Training

Therapists are often amazed when they begin to discover what it is to explore the full depth of core feelings in therapy, a process that is linked to positive outcome over and over again in clinical and neuroscientific research. Sometimes it looks like a patient is deeply experiencing emotion when they begin to weep or cry but underneath that may be a world of rage or shame. We need to be able to distinguish between core feelings and defense driven affects because if we encourage the latter, the client may become more depressed or we may activate other symptoms. Often we overlook or move too quickly past important affect signaling, and this can compromise the state of liberation and integration we are seeking.

These vignettes from one of Susan’s training sessions will help you to begin to differentiate defensive from core affects.

Susan began this lecture discussing projective anxiety. She explained that fear is a core emotion when it is based upon a real threat such as a true predator or natural disaster. However, humans are prone to generate anxiety by seeing themselves as incompetent and unimpressive, thereby assuming that others will automatically think less of them. Early experiences can cause us to anticipate that our feelings will appear stupid, excessive, overly needy, out of control and will potentially generate disgust, retaliation or abandonment. Too often the feared rejection or attack is actually being generated unconsciously within the self.

For example, the client may enter our office expecting criticism from us when, in fact, he may have an internal sense of unworthiness that he believes will be shared by the therapist. So, the client becomes anxious and/or ashamed or guilty about emotions believed to be unacceptable, disgusting or even evil. So, the threat of criticism, condemnation, abandonment or abuse in the consulting room is most often generated from traumatic memories that live in the body.

In this particular lecture, Susan teaches how we can deal with the defensive affects of projective anxiety and also weepiness. In the former case, Susan recommends a variety of possible collaborative explorations, including looking at what it is that the client fears. Once the client can identify the fear of rejection or criticism, Susan suggests the therapist can ask such questions as, “Do you experience anything like this coming from me? What do you notice that gives you the impression that I’m criticizing or rejecting you?” “What do you see as you look into my eyes?” “What is your actual experience?”

If the client says something like, “I see compassion,” the therapist can corroborate that this is true and it is good the client can recognize this. The therapist might then make a statement such as, ’Since you are able to see that there is no evidence that I am rejecting you, might we say that this is something coming from within you that you perceive to be coming from me instead and so your body signals danger? This type of fear of course makes it harder for you to open up to me and causes you to put up self protective barriers that can actually prevent me from helping you in all the ways I would like to offer you. Do you see what I mean?” If the client can understand this, then we see if the client would like to continue to observe and actively reduce this type of projective anxiety together. Just becoming aware of projective anxiety at its source, along with generating self compassion, often go a long way towards lessening it.

Susan now moves to the defensive affect that manifests as weepiness.

Susan: “You were asking about weepiness, right? And we do need to really differentiate the defensive affects from core feeling. And with core feelings, of course, we have the green light to explore these feelings to the fullest extent possible. However, we are not going to try to deepen weepiness associated with defense. So if someone is weeping we need to notice the context for the weepiness. If someone has just begun talking about something that we would assume made them very angry and then suddenly they have tears streaming down their face and they’re blotting their eye, then we can assume that weepiness is drowning out the anger. The tears are also understandable as anger is usually driven by hurt, and so there is surely sadness accruing as well. However, we want to try to access the most avoided feeling, which in this case is anger.

I might say, “I see your tears and there must be pain inside even though we may not fully understand its source. Yet you were talking about your husband talking down to you, and I’m wondering about your feelings towards him? Your tears may drown out other feelings you have, so might we take a moment to explore any other feelings you have?”

Or “Your tears may be a sign of anxiety about other feelings you’re having—are you aware of any anxiety in your body at this time?”

Also when weepiness is defensive, the therapist might feel annoyed or even angry because the tears are ambiguous and the therapists efforts to help seem to go nowhere. We can use our feelings of irritation to help us to recognize defensive weepiness so we can bring it to awareness in a constructive way. Not all therapies bring the client’s defense mechanisms and defensive affects to the client’s attention.

Would any of you want to venture an intervention here. How you might want to intervene?

Student: (this student is accustomed to not drawing explicit attention to defensive process): Now I just ignore it. When somebody’s weeping I just keep going cause I just ignore it. I don’t know if that’s appropriate or not.

Susan: You know, everybody has an opinion, everybody, so I’ll just share mine. My preference is to raise people’s awareness of their defenses and so that they can self-observe and I like it when my clients down the road will say, “Oh, I’m weeping again. I see that I was really just angry and then the tears came and I don’t really want to do this.”

And I also help people to see how it makes them small because it is a regressed state. So suddenly, you know, a powerful woman starts looking like she’s in a puddle and overwhelmed and can’t handle whatever the situation is. So sometimes I’ll point out how you’re making yourself so small here in the face of this really a powerful feeling of anger inside of you.

And I may also say, “I know there’s sadness. I know you’re hurt too. I don’t negate that there’s sadness.” But I might say to a person, “You don’t seem to have any trouble with sadness. You frequently seem to be able to get sad, but when you’re talking about somebody that clearly you have other feelings about, those feelings get abandoned. So what do you think? Do you see how this weepiness can be making you small, hurting you, pulling you away from other vital parts of you?”

BACK BY POPULAR DEMAND!

Save the date: 02/20/2016, 10:00 a.m. – 5:00 p.m

Susan Warren Warshow

will re-present her video from:

“Penetrating Defenses and Surmounting Shame”

This material has inspired comments such as:

• Best training I have ever attended!
• Susan was inspiring, genuinely humble, authentic and knowledgeable.
• This is my first exposure to DEFT, and I definitely want to learn more.

Susan will discuss the change factors in psychotherapy with a man who has ego fragility, fainting episodes (one begins to occur in session) and long term depression with disabling distancing defenses. Email us at admin@deftinstitute.com if you plan to attend. We will be choosing the location soon based on the response.

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