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Anxiety

Take Your Talk (Therapy) for a Walk

How to maximize the effect of eye-contact conversations.

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Most of the time when we have conversations with others, we make consistent eye contact with one another and sit directly across from each other. We do this at meals, at social gatherings, and even in therapy. These conversations can be simple: talks about sports, movies, and interests, or more complex: catching up on life and getting vulnerable. When conversations begin to get more vulnerable, sitting across from one another, and uninterrupted eye-contact, might feel more serious and intimate, as if we’re giving others access to our inner-workings. I have noticed that when talking with a client at our community integration program, easing up on the eye contact makes me seem a little less judgmental and makes them feel more at ease opening up about an issue. Taking a drive to talk or walking and talking makes a conversation feel less threatening for a client. This method of therapeutic contact is slightly unorthodox, but it’s very helpful. We especially use this model quite a bit with young adults in our community integration programs who are struggling with anxiety and avoidance.

Think about how this generalizes in both your personal and professional life.

  • Driving Talks – At work, I spend many hours in the car with clients to get them out into their communities as they rebuild their life. I enjoy the drives because this gives me to opportunity to encourage, motivate and help them while they reach their destination. Driving talks seem to create a safe and private environment where they feel comfortable expressing themselves. We say when we train new staff that you can either treat a client transport as if you’re an Uber driver, or you can make the time clinically meaningful. I prefer the latter. Our clients who struggle with avoidance do not like perceived confrontation, and this approach takes away that barrier. Fred Peipman, Ph.D., noted, “People say things in a car that they would never say on the street because there is a perceived separation.” In my personal life, I’ve had many car trips where family and friends open-up about issues that they would not share with their counselor, spouse or parents. Think about all that people share with their hairdresser, after all

  • Walking Talks – “Let’s take a walk” is something commonly suggested in our workplace when a client storms out of a therapy session or is feeling overwhelmed. Being able to walk side-by-side and get fresh air allows us to talk freely about an issue, while simultaneously deescalating a client’s emotions. Taking a walk at a park or trail down the street makes the client feel freer and less confined. I used to work with a client who didn’t feel comfortable meeting at an office, so we would meet at a park and run together to conduct our therapy sessions. He always reminded that being out in the open air made him feel less anxious. In my personal life, I try to take walks with my father to facilitate open communication. This tradition has honestly made our bond stronger. This method improves both of our moods and it keeps us active, mentally and physically.

Other research and authors have supported the claims that talking side-by-side can facilitate open communication. Carolee Belkin Walker stated in an excerpt from the Washington Post, “I’ve noticed a significant reduction in symptoms in terms of intensity and duration when comparing my outdoor clients versus in office/video conference clients. Teenagers seem to have an easier time opening up in a more organic way being outdoors and moving as well.” We’ve found that this generalizes into our program in the treatment of young adults.

Overall, I have found that walking and driving with clients can be very useful and helpful for their treatment. Talking in-tandem with visual distractions, such as nature or scenery, may allow for more fluid engagement. It also serves our team well when one of us discovers information about a client that we wouldn’t have gotten in the therapy office. While unorthodox, I would encourage you to give these approaches a try with anxious, shy or avoidant clients, and see how it works for you.

Author: Rob Pineda, Resident Advisor at Pathfinder

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