Leaning Into Love

The Radical Shift

By Maryhelen Snyder

Abstract:

The willingness and capacity to love and be loved on the part of both therapist and patient are core to optimally successful psychotherapy, both as a process and as an outcome. Developmentally and phenomenologically, the movement of love is a simultaneous inpouring and outpouring. The AEDP (Accelerated Experiential Dynamic Psychotherapy) model and, most critically, the moment-by-moment attentiveness of its practice, has opened new doors to the co-creation of mutual love.  Through the two quintessential elements of 1) observing and documenting the indicators of a transformance event and 2) mutually meta-processing the experience of embodied healing and connection, love’s potential is optimized.

Love

. . . Let me put my mind on my work
which is loving the world . . .
which is mostly standing still
and learning to be astonished.”

Mary Oliver (from Messenger)

Some years ago, I saw a play [Explain this Moment by Harry Wilson; unpublished] in which a grandfather is dying.  His young grandson has been at his bedside. Outside the bedroom, he asks his mother to “explain death.” “Some things can’t be explained.” she tells him. He protests this affront to reason: “Yes they can,” he says firmly.

The mother squats down, facing him, “ All right, then,” she says, gazing at him with great affection, “Explain this moment.” The audience is still. The moment becomes a shared felt experience of  its inherent mystery.

After a recent workshop, one of us asked Diana Fosha, founder of  AEDP, whether she had a mindfulness practice. With something of a chuckle, she said, “No, my work is my mindfulness practice.” Since applying this model, my work as a therapist has taken a turn toward a deeper understanding of the lived meaning of presence in this precise moment.

The present moment is where love happens.

Martin Buber described love by inventing a new word, I-Thou (Buber, 1958).  The I-Thou moment, virtually indescribable except in this poetic language, is nevertheless something we know experientially. In a dialogue with Carl Rogers (see Anderson, 1997), Buber said that the attunement that true meeting requires is not adequately described with the word empathy.  He preferred the word inclusion as a way to convey what it means

to step into elemental relation
with the other . . . to concretely imagine what the other person is thinking, willing, feeling . . . to risk a bold swinging, demanding the most intensive stirring of one’s being, into the life of the other.”

(Buber, 1988, p.71)

Paradoxically, this act of profound intimacy opens up boundless space for the other to exist in his/her own right.

“How can I be a mother to this child who is so amazing, as though she came from somewhere other worldly and doesn’t belong to me?” a mother who brought her three month old infant to our therapy session asked me, rhetorically. To be a parent (or a therapist) to a human being is an act much like midwifery in which we participate with awed, attentive presence as the direction for us to take unfolds moment by moment.

In AEDP, the phenomenon of True Self-True Other (Fosha, 2009, 2010)  closely parallels the I-Thou experience. We recognize it when it occurs, not by its nameable characteristics (the description of it comes after the fact), but by the subjective experience that in this state of being, we are somehow complete. It is the experience of being fully real, fully alive, fully connected.  The word “complete” fits because of the experience of there being nothing missing in this moment.  In the phenomenology of AEDP, it is the “core state.” We recognize it without ever being able to fully explain or define it. It is a grace state in that it comes to us. We do not so much will it as open ourselves to it, shifting our attention to this moment, suspending momentarily our habitual concerns and beliefs and thoughts, standing still and learning to be astonished.

The therapy session is a primary place where I learn what it feels like experientially to reiteratively make a conscious shift from separate self into open-minded presence to another. This movement virtually always feels bold and radical. I find it helpful to remind myself that stillness is the starting point, and that I not only do not need to know what I will do next, but I actually need not to know.

The Psychoanalytic Legacy

Sigmund Freud described psychoanalysis in a letter to Carl Jung, as “in essence a cure through love” (Gilligan, 1997, p. 96).  He warned strongly against the therapist coming to a session with an analytic mind, suggesting that all theoretical and diagnostic formulations be set aside so that the felt practice of Einfuhlung be all that remained.

Einfuhlung is a difficult word to translate. In the following passage  from Freud’s famous essay, “On Beginning the Treatment” Einfuhlung is mistranslated by James Strachey as “sympathetic understanding” (see Shaughnessy, 1995).

It remains the first aim of the treatment to attach the patient to it and to the person of the doctor. . . . If one exhibits a serious interest in him, . . . he will of himself form such an attachment. . . It is certainly possible to forfeit this first success if from the start one takes up any standpoint other than the one of sympathetic understanding [Einfuhlung] (Freud, 1913/1958: p. 140).

In 1913, the word Einfuhlung had only recently been introduced into the German language by Theodor Lipps, a psychologist, to describe the phenomenon of being completely absorbed by, and attuned to, an external event or object (such as a piece of art). It is taken from the Greek word empathiea (to feel into). It indicates personal resonance with a suspension of all theoretical models and interpretation (Shaughnessy, 1995).  In the same essay on the beginning of treatment, Freud states that the analyst “should simply listen and not bother about whether he is keeping anything in mind” (Freud, 1913/1958, p. 112).

The Radical Shift    

The discovery that we can intervene on our own subjectivity (our experience of experience) is arguably the most exciting aspect of becoming a person.

After my husband died in 1996, I was catapulted into living primarily in the present. When I walked on our tree-lined street, what showed itself to me was green that was really green, sunshine that was real  (Rilke’s words in “Death Experienced”; see my translation of this poem in Snyder, 2008.)  My mind experienced no separation from tree, sky, self, other.

But there came a day when this depth of aliveness no longer occurred automatically. I looked at a tree, and the sense was one of recognition and naming: “There is that beautiful tree.” In that act of recognition and naming, I was separate. Then I noticed, not for the first time, that I could bring my brain out of separation into connection, what Buber called inclusion. In that moment, “aliveness” takes on a radically different experiential meaning. In the therapy session, my training is to listen as an outsider, to reflect on what I am hearing. Furthermore, I live habitually in what Einstein called “the optical delusion of the separate self” (Siegel, 2010a, p.255). In the practice of mindful listening to self and other, I notice that we are not quite together, my client and I.  In a sense, we are not together at all, although the observer might say, “Of course you are together, face-to-face, talking intently, listening intently.”

What moves me to notice that I am not attuned is my own deep need for connection, for mutuality, for inter-being (Thich Nhat Hanh’s term), for recovering the pre-verbal reality of a self-in-world, a movement-in-relation. The Stone Center psychoanalysts developed this latter hyphenated term as a definition of what a self is (see Jordan, Kaplan, Miller, Stiver, & Surrey, 1991).

In that act of noticing my disconnection, I am able to call myself to a radically different place. The state of love is radically different not only subjectively, but also physiologically and neuronally. It is not within the scope of this article to discuss the neuroscience of brain shifts.  Daniel Siegel’s “Mindsight” and “The Mindful Therapist” (2010a, 2010b) and “The Healing Power of Emotion” (Fosha, Siegel & Solomon, 2009) are an excellent place to start exploring this significant domain.

In “The Healing Power of Emotion,” Fosha writes “the basic quality of emergent experience is a surrender to the experience of flow, of being in the zone.” (Fosha, 2009, p.222)  The word surrender is key here. The therapist and client, in a dynamic interflow, are allowing wave after wave of clarity, insight, and transformative affect to happen in body, brain, and relationship (the three points of the triangle with which Siegel defines the human mind) as a “relational and embodied process that regulates the flow of energy and information” (Siegel, 2010a, p. 52).

Science and Art

In a brief, succinct chapter on “Analytic Love” in Retelling a Life, Roy Schafer (1992) references the psychoanalyst, Hans Loewald, and the poet, Rainer Maria Rilke, as two thinkers who understood love as a focused attentiveness that necessarily moves the therapist/artist beyond the limits of a theoretical model into the “face-to-face.”  Schafer quotes Loewald as follows:

It is impossible to love the truth of psychic reality, to be moved by this love as Freud was in his lifework, and not to love and care for the object whose truth we want to discover. All great scientists are moved by this passion. Our object, being what it is, is the other in ourselves and oneself in the other. To discover truth about the patient is always to discover it with him and for him as well as for ourselves and about ourselves. And it is discovering truth between each other, as the truth of human beings in their interrelatedness (Loewald, 1970; pp. 297-298).

Rainer Maria Rilke spent many hours in four rooms of a Paris gallery in 1906 (the year of Paul Cezanne’s death), immersing himself in a retrospective exhibit of the artist’s work.  Rilke’s daily letters to his wife, Clara, reveal the flow of insight that resulted from this immersion (Rilke, 1985). The following passage is reminiscent of Freud’s words quoted above from “On Beginning the Treatment”:

[Sentimental artists] paint: I
love this here; instead of painting: here it is. In which case everyone must see for himself whether or not I loved it. This is not shown at all . . . It’s that thoroughly exhausted in the action of making, there is no residue.

            Ideally an artist should not
become conscious of his insights; without taking  the detour through his reflective processes, and incomprehensibly to himself, all his progress should enter so swiftly into the work that he is unable to recognize them in the moment of transition.

(Rilke, 1985; p.51)

As theoreticians as well as therapists, we must set aside, as Freud so clearly points out above, our analytic mind as we work. We must surprise our own unconscious as well as the patient’s.

Becoming the Other

What struck me most in my first encounter with Diana Fosha’s work, was that she allowed her own feelings to come to the fore as they arose in the process of attunement to the client’s not yet explicit feelings. Thus, she gave language and affect to the implicit, feeling for the client what he/she was not quite able to feel until she experienced Fosha’s affective attunement This depth of attunement is an essential aspect of making the implicit explicit and the explicit experiential. Before discovering Fosha and AEDP in 2001, I had begun using a method I call “becoming the other” (Snyder 1995, 2009) under the circumstances that the patient is not yet able to feel a significant emotional event or that I momentarily feel somewhat blocked in my own ability to attune to the implicit emotions of the patient. As I speak in the “becoming the other” mode (i.e. as my patient), I touch the emotions that have been implicit. In doing this, I invariably experience some of the “transformational affects” side-by-side with my patients (e.g. the “tremulous affects,” and “mourning the self”) Fosha, 2009. Since discovering AEDP, I have also noticed how much “dyadic affect regulation” (Fosha 2001) is continually going on between patient and therapist in this process.

Strategies of Disconnection

When the therapist risks inviting a high degree of mutual respect, mutual empathy, mutual authenticity, and mutual love in the therapeutic relationship, the barriers to connection that typically occur over the course of psychotherapy will become more evident. Primary among these are what Judith Jordan (1998) has called “strategies of disconnection.” Frequently the therapist experiences these strategies by feeling their correspondence in the counter-transference.

These “strategies of disconnection” are developed out of the necessity to stand up for ourselves and to protect ourselves from potential hurt.  Furthermore, they are always in the service of deeper, more authentic connection. For example, the young child’s “I hate you!” is initially spoken relationally. It is not so much a withdrawal from attachment as a cry to not give up our free spirit in the service of false connection.  We rage against the dying of the light[1] that is our birthright.

D. W. Winnicott’s essay on “Hate in the Counter-transference” (Winnicott, 1994) clarifies how the felt experience of “hate’ in the lived moment is in no sense the opposite of “love” as we are describing it here.  Rather, it is an authentic response to a violation of the “true self.”

Jordan describes how the therapist might easily experience either a tendency to respond with a strategy of disconnection of his/her own, or with an attempt to quickly repair the strategy of disconnection exhibited by the patient. Neither of these responses will suffice, since both of them omit the deep level of attunement necessary for change.

Boundaries as Integral to Love

I will put Chaos into fourteen lines
And keep him there. . .
I have Him. He is nothing more or less
Than something simple not yet understood
I shall not even ask him to confess
Or answer. I will only make him good.”

(Edna St. Vincent Millay)

The therapeutic relationship, the healthy family, the constitutional democracy, are examples of containers with parameters that keep us safe in the more or less “strict confines” of  “sweet order.”  Our clients come to us with the need to work through terrifying emotions and irrational behaviors. Millay’s clarity that Chaos is “nothing more or less /than something simple not yet understood” reminds us how in the healing process every chaotic emotion and impulse is eventually experienced as relevant to our necessary human needs.

CASE TRANSCRIPTION

El: Background

El’s life-long habit is figuring things out, analyzing them, reporting on them, designing them.  She is now 65 and living alone. Most other relevant biographical information unfolds in the transcript (in disguised form, for the sake of privacy) and doesn’t need to be summarized here.

As a newborn, El was separated from her mother shortly after birth and spent three days in a hospital before they knew as much as they know now about the traumatic effect of such an early separation. Many later experiences reinforced the unbearable loneliness that is the key factor in turning early attachment trauma into pathology (Fosha, 2000, 2009). Figuring things out became her lead strategic defense.

Since this is also one of my own defensive strategies, it is relatively easy for me to get co-opted into a dyadic process that keeps us both “in our heads.” My work with El has become an excellent laboratory for the practice of moment-by-moment presence and the radical shift which that often requires of me.

When I asked El in an early session if she had any memories of feeling totally safe and connected, for a while, nothing came to her mind. Then two categories of memories came, each a bit tentative but nevertheless significant: moments of being with her own babies and the experience of “love-making,” of sexual connection and satisfaction.

In a subsequent session, I pulled my chair somewhat closer to where she sat, to a place where my own eyes could meet her slightly anxious but interested gaze and invited her to stay connected for just this moment to what it was like to look at each other. When she allowed herself to feel our connection, it broke through her isolation and she cried. I invited her to play “peek-a-boo” with our face-to-face connection, covering her eyes with her hands when it got hard to look and be looked at, then opening them for just a brief experience of the warmth of my gaze. This intensified both her tears and her trembling (transformational affects).

Since El had to travel to see me from another state, our sessions were two hours in duration and often three to four weeks apart. She has been in therapy for approximately a year and a half. In the session just previous to the main transcription below, El had a major breakthrough into self compassion and connection with me. I have transcribed a brief part of that session here because it is relevant to the longer transcription.  “Th” is  therapist; “Pt” is patient. I have put most process observations in bold print; “click” indicates a shift, a moment of transformative recognition with its various physical and verbal indicators.

Part I: Vignette from earlier session

El says that she feels she needs to grieve (“and release from my body”) the newborn’s experience of being kept separate from her mother for 3½ days after birth. She also speaks of “adventuring into the dating world again . . . without expectations.” She tells me that she  “may need to feel the grief of never having found the desired lover.”

I ask her to pay attention to the feelings in her body. She notices a tightness in her throat and chest and belly, an overall feeling of keeping herself “tight.”  “I feel like I’m holding myself in protection, holding me in . . . a barrier . . . I’m scrunched up.”  I suggest she put her arms around herself while letting her body stay tight, scrunched, and protected. I ask:

Th: What’s it like all your life to have to hold yourself in? (Attention to the embodied affect is essential. Here we are surprising the unconscious by making conscious and intensifying the physical symptoms of attachment trauma while at the same time holding these tenderly.)

Pt:  (Tears welling up). Oh, poor me.  (Pause. Click) It feels like grief and fear rolled into one. . . .  Oh, poor me.

Th: Notice how much tenderness there is in your voice. (Mirroring non-verbal cues. Dyadic affect regulation; we are in this together.)

Pt  (Tears increase with sighs and sobs.)  So big, so deep.  (Pause)  Sweet, precious baby.  (Pause. Click) That’s new, that word ‘precious.’ (Pause)  In the scrunch, there’s so much loss and shame.

Th: In the depth of that feeling of loss and shame, there may have been nothing in you at that time that could feel “poor precious baby.”

Pt: As though I could never get past those three and a half days of feeling so alone . . . Poor me stayed in that place all this time . . . (Long pause with eyes closed, gently caressing her own arms that are wrapped around herself.)  Poor sweet precious baby . .. (Click; looking up at me) I guess that’s the first time in my life that I’ve allowed myself to be in that space with myself.  I’ve gotten close, but I was too scared.

Th: The tears are the tenderness you’re feeling to the part that’s not ready yet?

Pt: Yeh. She’s not smiling, but she’s looking up. . . .(Click; pause) There’s no hurry for anything. (More tears) This is the opposite of the scrunchy feeling, this allowing it to be.

Th: You feel it loosening up a little bit?

Pt: The adult is wanting the fear to go away, but I’m saying, ‘no, just be with me.’

Th:  I’m moved, listening to you, that you can feel her; that she can feel her own grief after three and a half days of separation from the lifeline to existence. (Self-disclosure. By expressing this feeling I also intensify it in myself.  Via the dyadic affect regulation, we both experience the movement-in-relation that self is.)

Pt: Yeah, that’s what it feels like, lifeline to existence . . . I’m allowing me to be wherever I am. It seems to me that I’ve wanted to be in that space always, but from my head, not my body. And I’ve been wanting somebody to do it for me. (Click. Her face is very peaceful and inward.) Do you suppose that this is what intuition is, this listening to oneself . . . prior to thought . . . in the body . . . and bottomless.  It’s not exactly listening; it’s more like feeling and then letting words express whatever they can. She [the baby] keeps tuning what I say . . . (Tears)  I’m feeling how much I love this baby. . . . Then thought shows up again and says: “That’s why you love being with babies.”  There’s an emergent love affair . . . I’m feeling the edge of ‘it’s okay’ . … I have this weird sense of wanting to let go, and yet not . . . I know exactly what she [the baby] needs.

Th:  How about that? Feel that in your body. She knows . . . you know . . .  exactly what she needs. (We sit quietly together.)

Pt:: Her hands aren’t in a fist any more. . . . I’m liking this feeling of not having to do something – like closure, or conclusion . . . like being a monk and getting to meditate all day . . . just being with it . . . some deep feeling of peacefulness. . . . The baby really, really likes this feeling of being held. . . No one is saying: That’s enough now. . . . I can just keep holding her and if she needs to protect herself, that’s okay. . . .The thought is Arnold (recent lover) told me I was holding people off.

Th: The baby feels a sense of relief . . .that “holding people off” is okay, is honored by you. (recognition and affirmation)

Pt: (Click. Tears increase)  She couldn’t let go, knowing what would happen in this relationship with Arnold.  It wouldn’t be honored, held, allowed to do its own thing.  (Pause)  How can I tuck this away so it’s always present?  How do I keep this?

Th: Go back to your body, the holding. Ask her ‘how do we not lose this?’

Pt: (Click) Wow, there’s a feeling of gratitude. I opened myself up. … what I value most about it. . . . I opened myself up to you.

Th: I’m so glad you said that. And I’m on board 100% with you opening yourself up to you.

Pt: I allow myself to let you be on board 100%.  Most of the time I get that I have the answers.

Part II: A radical shift, mid-session

In this next transcription (of the session following the vignette above, there is a turning point part way into the session subsequent to what I consider to be a disruption  in our attachment. In the first part of this session, without quite noticing it at the time, I have not invited myself sufficiently into full presence. I am disconnected and often “in my head.” It is likely that El didn’t consciously notice this because the main problem that brings her to therapy is the isolation at the root of unhealed attachment trauma. In that chronic place of loneliness, she does not expect and cannot expect my full presence.

A: The Absence of Full Presence

Pt:  Okay.  So, me, so two things. One is I want to back to stuff about my siblings. But I’ve been doing a lot of thinking about that. And the other is, um,  I went to this retreat last weekend.

Th:  Uh huh.

Pt:  And, um, the topic was, Super Ego/Inner Critic.  I was a little disappointed that all they focused on this whole weekend was that part of it.  And not so much, um, the good parts of the, the super ego.

Th:  Mm-hmm.

Pt: And where the strengths can come out of the good parts of the super ego.  It was mostly focused on, um, the inner critic and, you know, and all that kind of stuff.  And we were doing this one particular exercise, which was kind of a Gestalt like thing.  And in that we kind of used the empty chair.  And the way the empty chair was used is, was, um, that you would sit, I would sit like here.  That would be the empty chair and I would kind of hurl the “shoulds” at the empty chair and then switch and get in the chair and experience what it felt like.  Kind of a felt experience.  Not as much a head experience, but really wanting to feel it.

Th: Yay!

Pt: Yeah, where you feel it in your body versus, you know, what are you thinking about it.  And I had this one particular experience that brought up a lot of feeling.  It was quite surprising to me in that, um, the “shoulds” that I was throwing out were about, um, I think it was about spending the last fifteen years in the darkness, in the woods, searching.  And not using any of, much of, the fifteen years to experiment with relationship. So it was, you know, my fifteen years of, okay, I’ve got to change something of what I’ve been doing so I can be in relationship in a different way and attract a different kind of relationship to me.  And so I was kind of throwing out a lot of, um, shoulds about how silly it was and how dumb it was to, you know, not to spend part of that fifteen years at least, you know, experimenting or being in therapy.  Kind of exploring that at the same time.  I was in therapy for some of it but that’s not kind of where the focus was.

Th: Mm-hmm.

Pt: And, um, so I got into the seat and started crying.

Th: Immediately?

I have been listening to the story El is telling me. I have not yet invited either of us into the present moment.  This step requires, if it is to be authentic and optimally effective, what Buber described as the intensive stirring of one’s being.  Short of that, both therapist and patient remain substantially alone.

Pt: Yeah, just boom. So then I’m throwing the “shoulds” about that and I get into the chair and begin to notice, you know, how is that feeling to me in my body?  And, you know, the, the, um, the, the hard place, the awful thing in the throat showed up and then the tears showed up.  And what I was experiencing was the – how do I describe it? What I was noticing was fear . . . and that I have to be in control of how the relationship is, who the relationship person is, how they are. And I was really kind of remembering a lot of stuff . . . and that’s when the, the tears showed up a lot.  And I, what came to me and what I was experiencing was the fear.  And the fear, I figured out, is about the control, having to do with, if I make it, shape it like, you know, like Play-Doh, or clay and I can put in the exact form that I think it needs to be or should, then it’ll be okay and it won’t fail and I’ll be okay.

Th: So you cried.

Pt: Yeah.

Th: You cried and cried and cried.

Pt: Yeah, yeah.  . . .And then I get this fear, this scared part of me shows up that wants to be able to let go.  And is afraid if I let go I won’t know what to do.  I won’t know how to be.  I won’t, I won’t have enough of, um, enough learning, enough experience, enough.

Th: So, so pause for a minute.  Stop talking about it if you can and feel it.

B. Present-time Technique vs. Present-time Presence

In the following segment, I begin to actively use more experiential methods of therapy. Important material is uncovered but, because I have not made the radical shift to full presence in my own being, these methods are not yet deeply healing.

Pt: It feels awful.

Th: Do you notice where in your body you feel awful?

Pt: In here and here, two places, (She puts right hand on her throat and then on her belly.)

Th: And starting with those main feeling places . . .your throat and your belly . . .  stay right with those feeling places even if they don’t have words for a little while.  Let the words bubble up out of the feeling places.

Pt: Feels . . feels like a stuckness, a poking.  Like a, it’s like a stopper.  You know like a drain stopper or a cork, you know, that’s in there to keep stuff down.

Th: (Softly, speaking to the feeling centers of the brain.) Yeah, yeah, yeah.  Stay right there.  See what it is . . . feel, feel the feeling that works like a stopper to keep stuff down.  And feel the stuff that’s being kept down and if it wants to make a noise like  (I make a noise like an outcry.)

Pt: Hmm, it’s more like a growl.

Th: Okay.

Pt: A growl like  (growls). . .  and pushing.  It, it keeps wanting to push the stopper out of the way.

Th: Uh huh.  Would it help to put a pillow over your mouth to let, to let it really growl hard.  Just grab a pillow and do that.  But let that voice, right from that place that’s tight, let that voice make the noise it wants to make.

Pt: (Growling sound – into a pillow)  Makes my throat hurt.  (Coughs) I just had this very bizarre thought.  And it’s truly, truly bizarre.  So this, that, that sound…

Th: Yeah.

Pt:  . . .of wanting, feeling like I, I want to be free.  I want to get this block out of the way is, it, it’s old, old, old.  You know, like the suppressed me from when I was this big (She holds her hand at the height of a small child’s head.). . . has been stuck here wanting freedom of, of, just free.

Th: Just free.

Pt: Just free. But the sound, this is the bizarre part, reminded of me having sex. (Pause) When I am free and I let that part of me out, it has a big voice.  And I have said for the longest time that my sexuality was the one thing my mother never got her hands on.  Never had influence on me.  Never had her clutches in, never suppressed.  That was always mine.

Th: Wow!

Pt: Is that bizarre? . . . Yes, yes, yes.  It was all mine, it was all me.  It was just pure me.  So is that bizarre?

Th: And maybe also wonderful.

Pt: I think it’s bizarre that the two things that, that, that’s what came up.

Th: All this stoppage was about being careful, careful, careful, careful, careful in relationships.  And sex is like,  “Not now.  I’m not going to be careful now.  Not at this moment I’m not going to be careful.”

Pt: Careful is so about not making a mistake.

Th: Mm-hmm.

Pt: It’s so, it’s so interesting.  I was describing this to Bob (the new man in her life) the other day and I couldn’t say it.  He said kind of along the lines of what you’re saying.

Th: Uh huh.

Pt: He just picked right up on it.  He says, “So you’re scared shitless you’re going to fail.“ Yeah, (Chuckles) How come I didn’t get that?

I am omitting here a section in which I mistakenly engage El in a discussion about this interaction with Bob that takes her away from her feelings.

Th: So then back to sex, I don’t want to jump too quickly out of your feeling that it’s bizarre. So just stay with the feeling that it’s bizarre to associate that big growl with sex.

Pt: Well what was, what’s bizarre to me, what felt bizarre to me in that moment was having that connection with this feeling, this sound, this wanting to push past the repression and uncork.  And having this connection to, oh, that’s what I do when I’m having sex.  It, it is uncorked.  I am uncorked.  The voice is there.  There is no repression.

Th: Yeah.

Pt: I’m just, I am fully in me.

Th: Yeah.  Maybe “delightfully surprising” would be another way to say “bizarre.”

Pt: Yeah.  [Chuckles]  That would be better.

Th: Like kind of, oh yeah.  Speaking as El: “There is this part of me that knows experientially . . . there’s this me, this sexual part that knows what it’s like to be uncorked, out of control.”

Pt: And, and, and free to be in my experience completely.

Th: Yeah. (These “yeah”s are spoken in a spirit of co-celebration.)

Pt: That’s kind of been…I guess that’s the one place in my life, my life experience, where I really allow myself to be totally present, to be uninhibited.

Th: Yeah.

Pt: And, well, the other part of it is the recognition from way long ago that, you know, I, I put on this thing that it’s the one place my mother hasn’t been able to get to.

Th: (Softly) Yeah.

Pt: That, that, and I’ve always thought of it as this is mine.  This is all mine.

Th: Yeah.  How about that?

Pt: This is all me. After pause. Yeah.  Hmm.  Though I’ve been thinking about, you know, this experience on Sunday at the retreat.  And being in this relationship.

Th: Uh huh.

Pt: And the…hmm.  Really wanting to practice the art of not being in control of it and having fun with it and enjoying it so, so that the weekend was about the inner critic and that part of the super ego.  And, you know, I got to see a lot of ways I do judgment.

Th: Mm-hmm..

Pt: And, and that I think is what got me to that place about relationship. . . And, and, and how I’ve created this fantasy image of who the person I am meant to be in a relationship with is supposed to be.

Th: So I want you to try something here.  Let the empty chair be the core self, the wise guru or the good mother but something way outside, way outside the controlling super ego.  Way outside the managing super ego, even in a sense way outside the thinking self.  Let it be light itself, the Buddha, whatever works for you.  And say okay I’ve come to this realization.  It’s big in me, this fear.  And it’s big in me, this inner manager.  I don’t know how you would want to formulate it.  And I want to ask what should I do?   Or how can I let go of this? And don’t predict what the Buddha will say.  Or is it the Buddha?  You pick, you pick whatever you’d like.

As I reflect now on the use of this technique, I notice how my use of myself as the wise and loving presence did not occur to me as it spontaneously does later at the moment of the “radical shift.”  In the absence of attunement to self and other, I use a “technique” rather than focusing on presence. I have not fully noticed how connected I already am to El (see moments above of co-celebration and deep empathy).  I have overlooked opportunities for meta-processing that would have elicited the healing emotions.  This is something that can happen to the most skilled among us. It is exciting in supervision groups and in the self supervision that we are doing as we work and as we write, to notice these lapses in presence. If we set aside reflexive embarrassment and shame, we feel gratitude for the capacity of the mind to be mindful of itself.

Pt: Buddha works okay.  Hmm.  I think the question is . . .  it’s something like “what am I supposed to do now?”

Th: That’s great.

Pt: The Buddha says, “It’s in your heart.” (Long pause) The Buddha says it’s time to relax.  It’s time to relax.  It’s time to let go.  It’s time to be.  (Pause) I was remembering . .  .[from our previous session above] whenever that other stuff shows up, just love it.  Just love it.  Love it from being in your heart.  (Long pause) Yes, yes especially the loving it part.

Th: (Softly) Yeah.

Pt: It’s especially, especially the loving it.

Th: Uh huh.

Pt: All of it, just loving it.

Th: Yeah.

Pt: Instead of what I usually do, go up here and start trying to fight it.. (Pause)  Just love it.  Love it, love me.  I’m remembering the times that we’ve been with the baby and . . .  (Her use of the word “we” reveals how much she has let me in based on our previous work together. But I don’t “notice and seize” [Prenn, 2010] the present time opportunity here.)

Th. Uh huh.

Pt: . . . and loving it

C. The Shift:  Let Me love The Baby

Th: Okay, let me put a little bit of a hold here.  I have to go to the bathroom. It won’t take me longer than a few minutes. I’m going to go upstairs in case you want to use this bathroom.

When I physically left my therapy office, I more clearly noticed what I am calling “the absence of my presence”.  I became more aware that my own needs for mutual connection were not being met.  The connection (attachment, love) needs of the therapist can be a powerful motivator for doing authentically relational therapy. In what follows, transformational experience occurs as the patient is no longer alone.

Th: So coming down from upstairs just now, I said to myself, “Hmm, not a bad idea to take a little break.”  I just thought of where we may need to go.  And what about you, El?  What were you doing while I was gone?

Pt: I was writing down the place I got to.

Th: Will you tell me what you wrote.

Pt: I wrote down:  Love, love, love – all the parts that worry, that want to control, that are afraid of failure, that feel lost and scared, the judging parts, – and love the baby again and again and again.

Th: Wow! Yes. Again and again, loving that baby. And can you also let me love that baby again and again?

Pt:  Wait. (Click. Head in hands, breaking into tears)  When you said that, what showed up (crying deeply), what you were already understanding, is that I get afraid to be loved. That’s what all that’s about.  I’m afraid it’s not real or it’s not going to . . . it’s not really for me.

Th: (Very softly)  Yeah.

Pt: (Sighs)  I had never really had that come together in quite the same place before.

Th: Before this moment? It came from a very deep place?

Pt: Then there’s that same cork in the throat thing.

Th: Yeah.

Pt: That…hmm, after all the huge, many times of tears and everything, there’s still so much fear and hurt.

Th: Yeah.

Pt: Bottled up.

Th: In particular, a big terror about being loved.

Pt: That it’s not real, it can’t be real.

Th: Yeah.

Pt: It can’t be for me.

Th: So  let me just repeat the way I said it that made those tears come up just like that.  I said, “Let me love the baby.”

Pt. (Crying)  Not quite sure what that is, what it is when you say that …what it is I’m experiencing that makes me cry.

Th: You’re not sure what that is.

Pt: It sure makes me cry though.

Th: (Gently) It sure does. (Pause, in which El continues to mourn.) Yeah.

Pt: Maybe…I don’t know.  Maybe because I’ve wanted that so much.  And haven’t been able to feel.

Th: Yeah.  That’s a good guess.  And feeling it from the inside, um, that terror of being loved, it’s tricky, isn’t it, because this goes all the way back to being very, very, very little.  And we know that a baby who’s been abandoned like that, left alone like that, that the terror takes the form of not seeming to be looking for it at all anymore.  It’s too scary to look for it again or that’s the words we would give to it as adults.  But the baby doesn’t think it through, the baby just doesn’t want to ever go through that again.  So leaving all that analysis aside for a moment, let me add one more phrase here and I don’t know if this will work but you know how a baby is, you do know how babies are.  You’re very good with babies. You know this double experience with a baby, that the baby – when all is going well, the baby’s being loved and the baby is simultaneously loving.

Pt: Mm-hmm.

Th: So I just want to add, let me love the baby and let the baby love me. (Pause)  Okay?  Now that might not happen like immediately. I’m looking at your face and thinking your eyes say ’yeah I’m up for it.’

Pt: I was just realizing how easy it is for a real baby who’s unencumbered.

Th: Yes, exactly.  So at some point the two go together.  But in the beginning of healing from something so hard as the kind of abandonment you must have experienced to be so terrified of being loved, to begin to heal, the first act is to tolerate letting it in and to not feel like there’s anything wrong with you.  That’s hard.  And this might take you also to your siblings.  I was thinking about that upstairs that you came in with two agendas.  And one of them was your siblings and one is this thing that came up at the retreat. (Pause. I realize I’ve left the relational moment with El too soon. Is this my own fear of letting her love me?)   I do love the baby, El.

Pt: I want to be able to feel that without crying.  Without it being the hurt that is showing.

Th: Yeah.  But those tears are healing tears; they are grief for yourself. You can’t be in a rush.

Pt:  (Click. Her face is shining.)  That helped.  I’m beginning to feel like the words from that song, you know, being in love and delight, joy and delight.

Th: Turning, turning.

Pt: Uh huh.

Th: We come out right.  You could feel that feeling?

Pt: Yeah.

(We laugh together.)

Pt: Yeah.  That …that’s what it feels like when I look into a baby’s face and they’re looking at me. We’re both smiling at each other.  Her eyes are shining and you just can’t help, you know, have that feeling of delight and joy.

Th: And it’s helpful to remember that you wouldn’t be able to love that baby in you, the way you do, unless you’d had moments just like that in which you felt loved and loving at the same time. And that is trustworthy.

Pt: Mm-hmm.  I’m realizing that some of the fear is somehow, somewhere along the line I must have hooked up a connection of when it doesn’t work, then it disappears. It goes away. It left me.

Th: Yeah.

Pt: And, and what I’m hearing you say is, ‘no, that that piece doesn’t go away.  That’s in here.  That stays in here.”

Th: Yeah, exactly. My guess is that probably with everybody with whom you have been in an intimate relationship, there was something at moments.

Pt: Yes. (Her face is peaceful, happy.) (Although this insight is being formulated by me, it meets her in a place that she made ready with her image of connecting with a baby in a two-way moment of love.)

Th: That’s a very strange thing.  I mean I was thinking how when Ross  [my husband] died, how when Ross died, all the conditionality of his love for me, which just seems to be part and parcel of being a person in the world, you know, disappeared.

Pt: Mm-hmm, mm-hmm.

Th: And when I picture him now, there were enough moments when he looked at me spontaneously with that look of adoration. You know, close to worship.

Pt: Mm-hmm.  I call it cherishing.

Th: Cherishing, pretty word.

Pt: Mm-hmm.

Th: So I really want you to know, and I don’t always remember as a therapist to make this really visible to you, that there have been numerous moments when I’ve cherished you.

Pt:  (Sighs)  It’s good that you say “moments” to me because my concrete little old brain wants to think of it as always.. .  . (Click). And it’s another connection I’m making that somewhere along the way that I created a thing about that love feeling; those moments are supposed to be always.

Th: Always.

Pt: And when they’re not, then it’s a failure.

Th: Yeah, wonderful to see that. Safe attachment doesn’t come from there being no break ever in that attachment. Love is in moments. Always moments. And then there is a break. And it might be a rupture. Or it might just be a rest. And if it’s a rupture, then the security comes from the repetitive experience of repair of that rupture.

Pt: Mm-hmm.  Um, I, I’ve been stuck in rupture.

Th: Yeah.

Pt: I’ve been stuck in this idea that it’s, that, that there’s nothing after the rupture.

Th: Yeah, doesn’t that make sense, too.  If the rupture went on and on for you those first few days, on and on way beyond a baby’s tolerance for it.

Pt: Well, but I think there was also attachment after that and then rupture and it’s the repair part that would be missing.  And then it would start all over again with sort of like an attachment but then there would be a rupture but then there wouldn’t be the repair.

Th: Yeah, and you’re talking about your mother?

Pt: Yeah.

Th: Yeah.  So there would be periods of attachment.

Pt: Yeah.

Th: Then periods of rupture.

Pt: Yeah.

Th: But the rupture experiences weren’t repaired in a timely manner that would make you reconnect . . .

Pt: Yes.

Th: . . . to the previous attachment.  (Gently) How about that?

Pt:  (Click. Crying) That’s what is so missing.  That’s what I . . . I feel like I’ve always been searching for is the repair.  “When will you come back?” That’s what the baby wants.  “When will you come back?”

Th: Yeah.

Pt:  “Come back!!” It’s panic.

Th: Yeah.  You know that feeling, don’t you?  Right here and right here. (I touch my throat and belly.) It makes sense to turn it into Play-Doh and see if you can shape it so it will be back or not go away at all.

Pt: (Tears) Yeah, yeah.

Th: (Softly) Yeah.

Pt: It’s just, it’s so amazing, those three words, just feels like it’s so clear.

Th: Attachment, rupture, repair?

Pt: Uh huh. It just, it feels like,. . . oh, the whole thing just got put together.  I can see it now.  I can see what the picture is.  I understand it.

Th: And moments.  I want to put the moments in because that’s really important. It all happens in present moments.

Pt: Okay I’m done. (meaning,I feel complete. Her expression is deeply peaceful.)

Conclusion

The co-creation of love in the present moments of a therapy session is core to the AEDP approach.  As therapists, we are likely to be embedded in the same isolating societal practices as our clients. Speaking for myself, in spite of my ongoing work on my own healing, I can be invisibly defended against the miracle of the human capacity for mutual love.

It is necessary to break through our own quiet resignation to isolation and step boldly, as Martin Buber observed into the experience of one human being fully meeting another. It is not enough to be a good listener and to apply the skills of empathic listening. We must become rigorous at noticing our detachment. In the transcribed session above, I have documented my own single-session journey as a therapist from an absence of full presence to noticing that absence and finally to a self-correction that allowed both myself and my client to lean more fully into the healing power of love.

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[1] From the Dylan Thomas poem, “Do not go gentle into that good night.”

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