Eye Contact in Therapy Part II

How to Look at Your Therapist

Posted Feb 22, 2012

Jeepers creepers...

A kind reader let me know that Part I was stirring up discussion in a psychotherapy chat forum under the heading: "Quick - what color eyes does your T[herapist] have?" A clever participant, apparently familiar with this dilemma, expanded the topic to: "What's the color of...:"
  1. Your T's eyes
  2. Your T's favorite pair of shoes
  3. The floor in T's office
  4. T's door
  5. T's clock

Funny stuff! Thanks for reading, PsychCentral folks. 

Part I took a look at why some people have difficulty making eye contact in therapy. In short, the eyes express and perceive a tremendous volume of feelings and reactions. If you're not comfortable giving or receiving that much information, eye contact will be difficult. Today we'll talk about what you can do about it. But first, a preachy tangent. 

Tangent 1: I joked in Part I about this being a worldwide plague, but I think this eye contact problem really could become an epidemic. Not to wax Luddite, but we don't look at people anymore, we look at screens. Just go to a party, look up from your iPhone and observe. Whereas we once felt pressure to stop staring at the floor and engage one another for fear of social suicide, we now stare at less threatening, low expectation, beloved, always-paying-attention-to-me-without-judgment screens. Maybe we're getting worse at eye contact because it's a risky, often uncomfortable experience that's becoming obsolete. In the words of Sherry Turkle in Alone Together: "we seem determined to give human qualities to objects and content to treat each other as things." I'm surprised your computer just let me say that.

Back to treatment. Eye contact is part of intimacy and bonding, so let's find a way to minimize or overcome the discomfort. We'll start with the most common behavioral advice: focus on one part of the face (eye, eyebrow or nose), don't wear glasses or contacts ( = blurry vision), develop a routine (like "the triangle"), don't think about it, use systematic desensitization, or for the rock stars among you, try flooding

What's flooding? Direct exposure to the feared stimulus. I wrote to Michael Ellsberg, author of The Power of Eye Contact and founder of Eye Gazing Parties, who generously shared an example of a flooding exercise he calls eye gazing:

As someone who 'wrote the book' on eye contact, I do have some thoughts on how one might best bring more eye contact into a therapeutic setting.

  • I think it should be done explicitly. Since practicing more eye contact is inherently awkward at first, diving in without telling your therapist that you're trying to use more eye contact could introduce awkwardness into the session or relationship. Instead, I think bringing it up as an explicit topic and goal in the session makes a lot of sense.
  • If this is something the client/patient wants to learn, I would highly recommend a few minutes of pure eye gazing, without talking, to practice. Good eye contact while engaged in conversation is an advanced skill that takes a lot of comfort with eye contact. For someone who is just starting, a period of "immersion" via practicing ONLY eye contact--no talking--could be very powerful. It's intense, but then again, intensity is necessary at times for therapeutic results, right? Fortunately, I couldn't imagine a safer space to practice, experience, and process that intensity than with the support of a therapist. 
  • Eye gazing involves looking into each other's eyes without talking. This is not a staring contest -- blinking is fine! Here are some basic tips for practicing eye gazing: 
  • Do not try to look at both of the other person's eyes at once--you'll go cross-eyed! With both of your eyes, look at one of your partner's eyes. You can switch which eye you look, no problem, but look at only one eye at a time.
  • Keep a neutral facial expression. Don't force yourself to be "pleasant" or to put on a smiley face. Part of the power of eye contact is that it allows us to be vulnerable with whatever emotions arise within us, however pleasant or unpleasant.
  • Speaking of emotions, eye gazing can bring up a lot of them. As in all therapy, the practice is to feel them, give them space, and let them be, without judging right away. But don't talk about them *during* the gazing--just let them be. There will be plenty of time to talk about and process emotions after the gaze.

Helpful words from the expert. I'll second the recommendation that clients with this issue bring it up with their therapist and talk about it, despite the guaranteed awkwardness. If eye contact is a problem, you've both already noticed it, so it might as well become part of your work together. Which brings me to...

Either psychoanalysis or two people watching TV

Tangent 2: Seems like a convenient time to plug psychoanalysis, the therapeutic orientation that intentionally avoids eye contact. Analysis is all about tapping into the seething cauldron of your unconscious drives, which is easier without your therapist's mug. Analysts don't want their physical image to get in the way of projection and transference: theoretically, the blank screen and free association work better when clients stare at the ceiling. If you have an eye contact issue and the means to seek analysis, you may find it an interesting way to explore underlying issues without the social expectation of eye contact.

Speaking of underlying issues, why do some clients experience the "cognitive overload" of eye contact mentioned in Part I, and not everyone? It may be due to one of the aforementioned disorders (depression, anxiety, autism, etc.), but not necessarily. Some of us grew up watching eyes and faces that reflected pain, hurt, shame, criticism, disappointment or a depressed vacancy. When we look into another's eyes, we expect more of the same.

This brings me to another therapeutic intervention. Maybe therapy is the first place where care, understanding, non-judgmental acceptance and even a desire to fight for you is reflected in the eyes of the other. The entire therapeutic relationship can effectively change your experience of intimacy, including eye contact. The hard work might be finding a way to take in this acceptance. Maybe when you realize the world can be accepting and willing to engage you, at least some of the time, eye contact will bring more pleasure than pain. 


If you still prefer screens to people, at least you could go to my facebook page or website.