Aside from the experiencing scale, one of the biggest lessons I learned from my therapy coach, Dr. Alex Vaz, was psychological defenses.
Simply put psychological defenses are all the ways clients resist change in therapy. For instance you might ask a client how they are feeling and they'll tell you a story about what their boss did, not saying a thing about how they feel.
Or you might give a client homework, they'll agree to do it in session, and then the next week they come in haven't done any homework.
On the one hand they are asking for change, and on the other hand they aren't doing the things they agreed would help them change. Personally, it's more simple for me to call it resistance.
As a therapists trained in the old school family therapy models, we never talked about defenses or resistance. In fact we were actively taught that resistance wasn't real and was manufactured by the therapist.
While that's partly true, it's also true that client resist therapy.
Which brings us to hopelessness.
Sometimes clients fall into hopelessness as a way to resist feeling whatever they're actually feeling. I've seen the same with other feelings, like guilt.
I'll ask a client, "when your boss yelled at you, how do you feel?" And they'll say, "Guilty. Like if I would have done better he wouldn't be yelling at me."
Now this is nuanced, but I don't think guilt is the underlying feeling. She's feeling guilty and the guilt is saying, "if you listened to me you wouldn't feel this way."
The guilt is a way out of underlying feeling.
But what's the underlying feeling? We still don't know. But it's that underlying emotion which is getting the person stuck.
How do we know when hopelessness is resistance?
So hopelessness, guilt and other emotions can be ways to defend ourselves from underlying feelings?
How the heck do you know if the client's emotion is the underlying feeling or a defense?
Honestly? It's really hard to teach. If I'm honest I don't have it mastered yet myself.
I do it mostly through intuition. I try to feel my way through.
So I don't have a great framework to help you begin to decipher which is the underlying feeling or a psychosocial defense for your client.
And I think this is part of why psychotherapy has stalled.
Skills like this are so very important. They determine whether or not your working on the right issue. At the same time they are almost impossible to teach well, consistently.
And when you get it wrong, you can really end up hurting a client. For instance imagine being in a hopeless place, and your therapist says "naw, that ain't it. What are you really feeling."
That's so invalidating. It would be crushing.
My best advice, so far, is to stick with the experiencing scale. I think the deeper the experience, the less likely client's is to be using psychological defenses.
As always, as I learn more, I'll let you know.
Best,
Jordan (the counselor)
-Fin-
If you liked this post, consider reading this next. I think you'll like it ;) It's about gamifying deliberate practice to make it more engaging.
Jordan Harris, Ph.D., LMFT-S, LPC-S, received his Doctor of Philosophy in Marriage and Family Therapy from the University of Louisiana Monroe. He is a licensed professional counselor and a licensed marriage and family therapist in the state of Arkansas, USA. In his clinical work, he enjoys working with couples. He also runs a blog on deliberate practice for therapists and counselors at Jordanthecounselor.com.