Feelings, Thoughts and Behavior

feeling and thinking picFeelings are internal emotions that have both conscious and unconscious origins. They are neither right nor wrong, good or bad, necessary or unnecessary. We have no control over how and when they present themselves. We may try vainly to suppress them.

We do, however, have control over how and when we express emotion.  Some emotions – jealousy and anger come to mind – are commonly thought of as bad or undesirable. This judging of the feelings exacerbates their painful aspects and can lead to self-recrimination.  To deal with feelings and to be able to choose when to act upon them, it’s essential to respect them and empathize with them.

I often hear patients filled with self-loathing because they judge their feelings as useless or unhealthy.  When working with such patients, I emphasize the value of allowing feelings to simply be, without judgment or editorializing whether they have a point, are unfair or invalid, or should not be felt.  As we explore how to empathize with feelings – especially unwanted ones – we learn how, when, and to whom to express them.

Because shame, embarrassment and inhibition often interfere with the expression of feelings in therapy, it’s essential that the therapist provide a safe and nonjudgmental space to facilitate the necessary freedom that allows the feelings to emerge.

I encourage my patients to discuss their darkest, most hidden and shameful feelings even though as an analyst and human being, such feelings can run counter to my passionate commitment to remain nonjudgmental.  In these situation, I separate my patients’ feelings from how they affect the patients’ behavior.  I help the patient wrestle with how these feelings developed and consequently how they affect functioning and happiness.

Most difficult for patients to express are negative feelings about me, their therapist, whom they often perceive as an authority figure.  Whether these feelings stem from a negative transference or a disagreement with an interpretation, I encourage my patients to talk about these feelings and I help them work through them, especially if they are negative.  Most typically, patients (and people in general) don’t like to express negative feelings to the person concerned because they are afraid of damaging the relationship.  By providing a safe environment and with gentle encouragement, I allow patients to discover that they can express negative feelings about me and have our relationship survive intact.  If all goes well, patients eventually learn to empathize with whatever they are feeling, be it negative or positive.

I once had a patient whom I only saw for a brief time but whose actions illuminated how acting out feelings can be less threatening than expressing them with words.  After only a handful of sessions, the patient started asking personal questions about me, his anger only rising as I set boundaries and refrained from most self-disclosure.  As his anger increased, the questions about me became more intimate and hostile.  I worked on exploring the feelings underlying his insistence, but to no avail.  Finally, in what was to be our last session, the patient became so enraged that he stood up and threw the check for the session in my face and stormed out of the office.  One can only wonder what narcissistic wounds made it easier for him to act on his rage rather than express to me the underlying feelings that motivated such intense anger.

Because people so often think of negative feelings as destructive, they often find it easier to express them through action rather than words, often unconsciously.  While I tell my patients that I want to hear everything – the bad, the good, and the ugly – such direct permission is rarely enough to break through the fear.  Only after a prolonged period, in the therapist’s safe and holding environment, do patients feel comfortable enough to bring up upsetting or threatening feelings into the therapy space.  At this point, the treatment can deepen and progress towards understanding and change.