Control Mastery and Affects --what about feeling

• Mission Statement by Jessica Broitman, 11/9/96
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    • A Focus on Feeling by Ellen Dornelas, 12/27/96
      
      

Control Mastery deals with feelings according to the patient's needs, the patient's plan for therapy and for a particular session, the patient's history, pathogenic beliefs, personality, etc. Ie, as with most things, its very case and situation specific. In conducting therapy I don't often specifically try to "go for the feeling" as I find that this tends to make people uncomfortable, and therefore less likely to express their feelings. And in fact I dont necessarily believe that feelings are always the most important thing; sometimes the beliefs underneath the feelings are more important. And it seems that when patients feel safe, when at least for a moment their pathogenic beliefs are lessened, that's when they can get into and tell me about their feelings. Joe Weiss first talks about this in his early article on crying at the happy ending; in this he made the point that when people feel safe at the end of the sad movie, when the danger is past, then they can let themselves cry, whereas earlier when the movie was going on, they may have had to repress their sadness. I find that if a patient wants to be intellectual, or focused on the events or conditions or people in their lives --past or present-- its helpful to go with it, with no particular emphasis on feelings. And this seems to work best. Weiss talks alot about going with defenses, supporting defences in order to create conditions of safety in which the patient can him or herself become less defensive. For example, if a patient who was put down as inadequate in their family and thus feels insecure about their intelligence, is bragging to me about how smart they are, I never say "I think you may feel insecure about your intelligence". This makes them think that I might also question their intelligence, and tends to make them feel in danger, uncomfortable, and shut down. However in some circumstances I might say "I think you feel uncomfortable telling me how well you are doing, how smart your are" and I might say something supportive about how smart I think they are. And then they often are able to begin revealing how terrible they felt when they were put down in their family, and bring up these difficult feelings. But when a patient is telling me about some overtly self-destructive behavior (for example, having a temper at a supervisor, or practicing unsafe sex, or engaging in drug use) I may be more confrontational because often there is some kind of protection test going on and to pass the test I have to at least try to be protective, to say "dont do that", make some effort to protect the patient. This usually happens with people who were very unprotected as children.And in this case too, when a patient who was never protected tests me around that, and I try to protect them, then often feelings do come forward.

A recent passive into active test (where the patient tests the therapist by doing "actively" to the therapist what they had to endure "passively" as a child) a patient gave me brings out another example of the different ways I work with feelings. My patient was acting very depressed and hopeless. I listened carefully, tried to help her figure out what had upset her, suggested various things that might help including antidepressants, and she did not like that. I realized at that point (the patient had coached me) that she was demonstrating to me how it had been for her growing up with a very depressed, weeping mother, and that she needed me to tolerate her depression, her very sad feelings (which really were her mothers feelings in a way), and not try to 'fix" her, ie, not be omnipotent in any way. She had felt omnipotently responsible for her mother's depression, and had felt like a failure in her efforts to cheer her mother up. She wanted a model of not being omnipotently responsible for someone's sadness. Well, so when I realized that I just encouraged her to tell me all about her terrible depression, every miserable detail, to cry, etc. She came in the next session telling me how much better she felt, and how much better she had felt as soon as she had left the last session. So in this case, what I really was doing was tolerating her feelings and not taking them too seriously. And it was very helpful. I could go on, and think of other examples, but this is a start. Hope this is sort of what you're talking about.

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