Emotional Healing and Psychotherapy

It's not just in your head—what's happening in your body is important, too.

Posted Nov 30, 2018

As Laura shared her story with me, her eyes filled with tears. Recognizing the emergence of emotion, I invited her to slow down and notice the physical experience of her sadness with compassion towards it. She stopped speaking and focused inward. As she did, the sadness increased allowing her tears to flow unencumbered by conflict.

Laura cried as I quietly sat present with her making sure she felt safe and not alone. Soon the wave of affect passed. I then gently directed her to stay focused on what was happening in her body now that the sadness had passed. After about 60 seconds, she looked up at me with bright eyes. “I feel calm now,” she said. “I really was a very sad child,” she reported with newfound insight, clarity, self-compassion and recognition for how her parents’ difficulties had affected her.

Ever since I was a little girl, I wanted to become a psychoanalyst — like Sigmund Freud. And that is exactly what I did. And then I learned of an entirely new way of working where the focus was on giving the patient a healing and transformational experience.

I first heard about this new way of working in 2004. I was attending a conference on emotions and attachment. It was there that I first saw videos showing therapists skillfully and gently guiding patients into their emotions by focusing on the physical sensations that came along with each emotion. I had never seen anything like it. I was fascinated. Since that time, experiential methods have become my priority. I am now certified (and even supervise therapists in training) in an experiential form of psychotherapy called AEDP: Accelerated Experiential Dynamic Psychotherapy.

Whereas in my analytic work I listened passively to my patients, in experiential work I might say to a patient, “I am interested in everything you have to say AND I am wondering if we could slow way down for a minute to just notice what you are experiencing as you share this story with me about how your boss criticized you.”

This intervention helps the patient recognize not only what they are saying but also what they are experiencing as they are saying it.

Experiential work is therapeutic — healing and transformational — for many reasons.

Here are four:

Experiential work actively cultivates a mindful, non-judgmental, compassionate stance that helps a person become aware of his/her inner experience which changes the brain for the better.

Experiential work helps people get in touch with their core emotions (sadness, fear, anger, joy, excitement, sexual excitement and disgust) so patients come to know what they are feeling and learn how to use their emotions instead of being controlled by them.

Experiential work diminishes anxieties and other symptoms in predictable, reproducible ways, which is why it is considered healing-oriented as opposed to insight-oriented psychotherapy.

Experiential work teaches people to become their own therapist, giving them practical life skills to work with their emotions and the emotions of others in ways that are more constructive than they had before starting therapy.

To help illustrate the difference between “traditional” talk therapy and experiential psychotherapy (AEDP in this case), here is an example of what an intervention in each method looks like:

Intervention Example

Client: My boss really upset me this week. I did a huge report for him that wasn’t even my job and he didn’t even say thank you. In fact, he talked about it in a meeting like he did all the work instead of me.

Psychoanalytic Therapist: Sounds like you didn’t like that. Tell me more…

The traditional talk therapist is trained to focus on the content of the story. The therapist listens openly and makes interpretations to help create meaning. Insight, of course, is important and at the same time, I have learned that there is so much more we can do as therapists to create wellbeing. Attending to underlying emotions, for example, can help clients feel more alive and deal better with life’s challenges.

Here’s the experiential version:

Client: My boss really upset me this week. I did a huge report for him that wasn’t even my job and he didn’t even say thank you. In fact, he talked about it in a meeting like he did all the work instead of me.

Experiential Therapist: I see feeling in your face and I notice your hands are making fists. Do you notice that? Can we slow way down so you can stay with what is happening inside as you share your story with me now?

The experiential psychotherapist is trained to notice both verbal and non-verbal expressions of emotional and somatic experiences in the hear-and-now. By paying attention to the client’s emotional and physical experience, the therapist helps the client deepen and use adaptively their emotional experience.

The therapist always stands ready to help their client regulate anxiety and guide the client as necessary. Once the client is in contact with her visceral experience of anger (staying with the example above), the therapist helps the client work with that anger, processing it in healthier ways than acting out or acting in.

One example of how to process anger in a healthy way is using fantasy for the expression on an impulse. Another way to process anger is to stay with the visceral experience of the feeling.

There are many different kinds of experiential therapies: Accelerated Experience Dynamic Psychotherapy (AEDP), Affect Phobia Therapy (APT), Intensive Short-Term Psychotherapy (ISTDP), Gestalt Therapy, EMDR, Somatic Experiencing, Sensorimotor Psychotherapy, Psychodrama, Expressive Arts Therapy, and Dance Therapy, to name a few.

I gravitated towards AEDP because it was firmly grounded in current neuroscience and in how emotions can be strategically used to bring forth positive transformation. And in AEDP, the stance of the therapist is informed by excellent research in attachment. Providing a safe environment for the patient makes it possible for them to explore new parts of themselves that were, until now, too scary or shameful to approach.

To heal the mind, we need to experience the emotions that go with our stories. Typically our patients need help connecting to their emotions. The same way our clients avoid painful or conflicting emotions in their lives is the same way they will naturally avoid emotions in therapy sessions.

Avoidance is not intentional. It’s just how the mind habitually protects itself from pain. An experiential therapist works to make it safe for a person to get in touch with what they are feeling as they are sharing. This fosters openness and builds greater capacity for intimacy and authenticity.

Enhancing emotional capacity is a skill that translates into patients’ outside lives and offers a host of benefits including increased self-esteem, self-confidence, curiosity in themselves and others, calmness, connectedness, clarity, and overall increases a sense of vitality.

In addition, experiential therapy heals large and small “t” traumas, reduces emotional triggers and heals depression, anxiety and other symptoms by integrating brain cell networks in the deeper parts of the brain, like the limbic system.

Lastly, there is a personal benefit to working experientially. It is a relief to get out of my head and into my body. I feel more grounded and less pressured to come up with “brilliant” interpretations. It was a relief to learn that the mind naturally heals if we help remove obstacles and bolster self-confidence by focusing on a person’s strengths not only their suffering.

While my psychoanalytic education serves me every day in my thinking, my experiential training allows me to foster predictable healing in my patients who come in with anxiety, depression and other symptoms.

All therapists must find the models that work best for them and feel the most comfortable. Still, I encourage therapists to familiarize themselves with experiential ways of working. Learning to notice, deepen emotional experience, and process emotions to completion is truly a gift both personally and professionally and can be incorporated into most other methods.

References

Fosha, D. (2000). The Transforming Power of Affect. Basic Books: New York