Client with anxiety/depression who cannot access feelings

Replies to This Discussion

Permalink Reply by Susan French on October 13, 2011 at 1:30pm

Kathryn,

You mentioned that he's on 20 mg of Lexapro.  That doesn't sound like enough to make someone this "dopey" but it does sound like he might be altering his consciousness with alcohol or other drugs.  You might want to probe.  You might find that he's taking way more meds than that.  People often won't offer information about behavior that they are ashamed or uncomfortable about, like drinking, for instance, or pot.

 

I have some thoughts about clients who say they can't identify feelings.  Just in the course of regular hypnotherapy I've found that a lot of people don't have a great lexicon of "feelings" words.  

 

What I do with these clients is to ask them about their thoughts or ideas or even better, the words that they say to themselves (in their imaginations, ie, self-talk) about whatever the issue is, or about specific events.

 

I don't think a lot of people have learned to connect what we call "feelings" (ie, the physical sensations that accompany emotions, especially strong emotions) with verbiage.  I've learned to ask about what they're thinking, or even better, what they say to themselves about XXX (whatever the issue).

 

After you've identified self-talk, you can start to ask questions (without leading), like, would you say that that makes you angry, sad, etc., etc.  Once you give these people "feelings" words that they can relate to, it can go a long way towards promoting their inner awarenesses.

 

I don't think I would even bother, at least not at first, with cause.  I think I would ask this guy what he loves to do, what he wishes he could do, etc.  I think you really have to help him connect with whatever is going on the in present and to articulate that before you can start connecting past dots.  

 

If you achieve nothing but getting this client to know how he "feels," thinks, wishes about the present, you'll be accomplishing a lot.  

 

Truthfully, though, unless I'm missing something here, I get the impression that he is either heavily medicated, self-medicated or he's really, really mentally out of touch with reality, in which case, you probably would probably want to refer him out.

 

I also wonder if he hasn't been crippled by being over-parented (just an idle thought). Nonetheless, I would still try to get him into the present, first of all, and then move from there. 

 

In my opinion, the present is much more important with most our clients anyhow  than is the past.  We aren't therapists.  We are more behaviorists (by law, I think).  (Before you yell at me, Fable, and others, most of us are not licensed and credentialed therapists.

 

Let us know how it goes with him and good luck.

 

Susan

http://www.hypno4success.com

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Permalink Reply by Kathryn Beck on October 13, 2011 at 1:54pm

Thanks for the reply Susan.  Very insightful and helpful.

I thought the same thing about the medication, not enough to induce that kind of behavior.  I asked if he was any other medications or herbs, supplements, and he said only the Lexipro.  That he'd been on many different anti-depressants over the years and this one he's been on for a couple of years now.  I'll be sure to ask about drugs or alcohol next time. 

 

Good thinking about not being able to connect words with feelings.  

 

He may be crippled by over-parenting.  His mother was the one who called me and made the appointment.  I asked if he was wanting to see me, and she said yes, he was just too shy to make the appointment himself.  (I can understand that...I use to suffer from chronic social anxiety and I would make my husband do all my phone calls for me).  

Yes, you are right, connecting with the present is important.  I'm just SO curious to know how this came about.  He said he started seeing a therapist in high school, so what was he like before that?  What happened in his life?  I do hope at some point I can do regression work on him to see what comes up, but for now, I don't think it will be helpful as he is so disconnected in the present.

 

So much to think about.  Thank you so much!
Kathryn

http://www.imaginehealthandwellness.com

 

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Permalink Reply by Kelley Woods on October 13, 2011 at 9:23pm

Hi Kathryn,

Susan's reply is awesome. I would only add to it by commenting that I have often encountered clients who are disconnected from not just their emotional but their physical selves. This is usually a self-protective function and can be revealed through parts work.

Imagine an obese weight client, for example, who has dissociated from physical sensation, partly due to the discomforts of being overweight but originally due to some other trauma (abuse, loss, etc.) It's an incredible experience to witness such a client begin to awaken.

You might approach this client by first focusing on stimulating his physical sensations: teach him some biofeedback techniques, for example. Once he has regained control of these, you can apply the same strategy toward empowering him in emotional areas.

It's like a client recently complained to me, "My doctor tells me to relax, but he doesn't tell me HOW to relax!" Sometimes, it's our job to teach our clients how to feel again and that it's safe to do so.

Best wishes, Kelley

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Permalink Reply by Sharon Dill on October 13, 2011 at 11:00pm

Hi Susan & Kelly - awesome answers, and thanks for the learning.

Kelly, I agree with you totally - many people who have suffered trauma of some kind, disconnect from their bodies. I am beginning to think this is far more common than we could ever have imagined. I found a great little book on this by Peter A. Levine, PHD called Healing Trauma - A pioneering Program for restoring the wisdom of your body. It is only 85 pages but makes for interesting reading. His methods don't have anything to do with hypnosis - they are simple physical exercises, but they are good and they work.

Another author who deals with trauma and how it affects the body is Belleruth Naparstek - Invisible Hereos - Survivors of trauma and how they heal. This is a great book for understanding the physical & chemical changes that happen in trauma. The back of the book has 80 pages of meditations/hypno scripts to help the client start the journey to coming back & feeling safe in his/her body. Fascinating stuff .... Just thought I'd share .. :) 

Great answers guys, and thanks Kathryn for sharing - interesting case. 

Sharon

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Permalink Reply by Robert S on October 14, 2011 at 6:27am

Hi Kathryn

I noticed that his observation: " it was just blackness, but it was peaceful." is metaphor, so this could be made useful by asking - what kind of darkness, what kind of peaceful (Lazy Jedi Question)

 

=]

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Permalink Reply by Kathryn Beck on October 14, 2011 at 10:03am

Very interesting thought, Kelley.  Thank you!  

Kelley Woods said:

Hi Kathryn,

Susan's reply is awesome. I would only add to it by commenting that I have often encountered clients who are disconnected from not just their emotional but their physical selves. This is usually a self-protective function and can be revealed through parts work.

Imagine an obese weight client, for example, who has dissociated from physical sensation, partly due to the discomforts of being overweight but originally due to some other trauma (abuse, loss, etc.) It's an incredible experience to witness such a client begin to awaken.

You might approach this client by first focusing on stimulating his physical sensations: teach him some biofeedback techniques, for example. Once he has regained control of these, you can apply the same strategy toward empowering him in emotional areas.

It's like a client recently complained to me, "My doctor tells me to relax, but he doesn't tell me HOW to relax!" Sometimes, it's our job to teach our clients how to feel again and that it's safe to do so.

Best wishes, Kelley

• ▶ Reply

Permalink Reply by Kathryn Beck on October 14, 2011 at 10:04am

Thanks Sharon.  I'll have to look into those books.  :)


Sharon Dill said:

Hi Susan & Kelly - awesome answers, and thanks for the learning.

Kelly, I agree with you totally - many people who have suffered trauma of some kind, disconnect from their bodies. I am beginning to think this is far more common than we could ever have imagined. I found a great little book on this by Peter A. Levine, PHD called Healing Trauma - A pioneering Program for restoring the wisdom of your body. It is only 85 pages but makes for interesting reading. His methods don't have anything to do with hypnosis - they are simple physical exercises, but they are good and they work.

Another author who deals with trauma and how it affects the body is Belleruth Naparstek - Invisible Hereos - Survivors of trauma and how they heal. This is a great book for understanding the physical & chemical changes that happen in trauma. The back of the book has 80 pages of meditations/hypno scripts to help the client start the journey to coming back & feeling safe in his/her body. Fascinating stuff .... Just thought I'd share .. :) 

Great answers guys, and thanks Kathryn for sharing - interesting case. 

Sharon

• ▶ Reply

Permalink Reply by Kathryn Beck on October 18, 2011 at 6:23am

Good thought.  :)  (I'm a big fan of Jedi's).  :)

Robert S said:

Hi Kathryn

I noticed that his observation: " it was just blackness, but it was peaceful." is metaphor, so this could be made useful by asking - what kind of darkness, what kind of peaceful (Lazy Jedi Question)

 

=]

• ▶ Reply

Permalink Reply by Kathryn Beck on October 18, 2011 at 6:24am

I'm not completely familiar with biofeedback.  Can you provide some examples of tools I could use to help my client?  I see him again on Thursday.

Thanks!
Kathryn

Kelley Woods said:

Hi Kathryn,

Susan's reply is awesome. I would only add to it by commenting that I have often encountered clients who are disconnected from not just their emotional but their physical selves. This is usually a self-protective function and can be revealed through parts work.

Imagine an obese weight client, for example, who has dissociated from physical sensation, partly due to the discomforts of being overweight but originally due to some other trauma (abuse, loss, etc.) It's an incredible experience to witness such a client begin to awaken.

You might approach this client by first focusing on stimulating his physical sensations: teach him some biofeedback techniques, for example. Once he has regained control of these, you can apply the same strategy toward empowering him in emotional areas.

It's like a client recently complained to me, "My doctor tells me to relax, but he doesn't tell me HOW to relax!" Sometimes, it's our job to teach our clients how to feel again and that it's safe to do so.

Best wishes, Kelley

• ▶ Reply

Permalink Reply by Kelley Woods on October 18, 2011 at 7:35am

Hi Kathryn,

Here's a little explanation about how biofeedback therapy is used... Some hypnos have actual devices (a temperature reading device, for example) but it's not necessary. I use the imagery of the control room in a person's mind, teaching them how they can not only be aware of different sensations in various parts of the body, but change that awareness and even the physiology itself.

I usually start with guiding them into changing the temperature of a hand, for instance. Once they demonstrate control with that, we can move on to deal with other modalities, such as discomfort (or comfort!), tension, flexibility, sensitivity,etc.

The big deal about this is that we are empowering the client to realize that he does have control, over not only physical sensations, but his emotional ones, too. It's the ultimate in experiential work, in my opinion!

Have fun! Kelley

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Permalink Reply by Katie Sandlin on October 18, 2011 at 7:47am

My first thought would be drugs too.  Unfortunately, I have had a loved one go in that direction and your description set off all sorts of alarm bells in my head.

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Permalink Reply by Kathryn Beck on October 18, 2011 at 10:51am

Thank you Kelley!  

Kelley Woods said:

Hi Kathryn,

Here's a little explanation about how biofeedback therapy is used... Some hypnos have actual devices (a temperature reading device, for example) but it's not necessary. I use the imagery of the control room in a person's mind, teaching them how they can not only be aware of different sensations in various parts of the body, but change that awareness and even the physiology itself.

I usually start with guiding them into changing the temperature of a hand, for instance. Once they demonstrate control with that, we can move on to deal with other modalities, such as discomfort (or comfort!), tension, flexibility, sensitivity,etc.

The big deal about this is that we are empowering the client to realize that he does have control, over not only physical sensations, but his emotional ones, too. It's the ultimate in experiential work, in my opinion!

Have fun! Kelley

• ▶ Reply

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