Friday, May 6, 2011

How did that make you feel?

"How did that make you feel?" is such a cliched therapy phrase that I try to avoid asking anybody this question.

On the other hand, "how do you feel right now?" is often therapeutic gold.

I was halfway through a first session with a woman in her mid thirties. As a therapist, I am trying to do a lot in that first hour: understand who this client is, identify why they are coming to therapy now, rule out any emergency conditions, and above all, establish rapport. The session started well, but when I began asking her more questions about her marriage, the vibe changed. It was almost as if we were arguing a little bit, me curious about her marriage, her not wanting to go there.

"It's not my marriage, I've been sad for years before this."

I tried to explain how relationship dynamics can reveal how people relate to others in general, then I backed off. I was getting heady, a bad sign. I remembered one of my favorite therapist acronyms - WAIT - Why Am I Talking? 

"Ok. You've been sad for years..." I said. Neither of us was sure where to go next.
"How do you feel right now?" I said.
"I feel anxious. I hate feeling this way."
"What happens if you let yourself just feel anxious without trying to push it away?"
She didn't want to do this, but I convinced her to try it for 30 seconds.
"Now I feel sad."
"How is that?"
"It's better than feeling anxious. I feel calmer."

The whole vibe in the room had also changed. I felt calmer, less frenetic. I felt like my energy had come down from my head and into my body. The rest of the session flowed with a natural rhythm.

Feelings can sit on top of other feelings. They call this primary (underneath) and secondary (sitting on top) emotions. Particularly when someone is anxious, there is often another feeling underneath. Even though the primary emotion is probably something difficult, it almost always feels better when it has a chance to breathe in a safe environment.

This is something I practice myself when I feel all jumbled up inside. I find a quiet place and let whatever it is I feel just be there for a while without pushing it away and without trying to figure it out with my head. Usually, in time, the mud settles and I can see a little more clearly what is actually going on inside me. This doesn't "fix" the problem, but seeing clearly is often the first step to fixing something.


  1. Loved your WAIT acronym. I shared it with my students at MSU when I lectured about counseling skills in my Eating Disorder Prevention class. Listening is the most important aspect and this acronym is extremely right on!

  2. Thank you anonymous. Glad you found this helpful.

    It's usually just when I think I am saying something brilliant that I need to remember WAIT the most.

    I heard this acronym from Dick Schwartz, the creator of Internal Family Systems therapy: Not sure if he came up with it himself or not.