What Are We Doing and Why? The Touchstones of Undoing Aloneness and Reflecting Worthiness
A new client began to cry in the middle of our second session. She immediately turned away in shame, hiding her face behind an impenetrable wall of curly, dark hair.
I gently asked her what had happened, there in that flash of a moment of turning away.
“I hate to cry. It’s weak.”
I only knew a little of her history, but enough to imagine my way into her experience. “If your dad was so cruel to you with his words, I can imagine that he might have humiliated you for crying.”
A vigorous nod, while still looking away. “Yeah. He used to yell and yell at me until I cried. Then he’d laugh at me for crying.”
“Oh man. That makes me so sad.” My head feels heavy, my eyes damp, physically sharing the essence of her held-back tears.
“Do you want to know how I see your tears?”
Pause. Shy nod.
“That your tears are showing up right now with me, when we’re just getting to know each other, tells me two things. One, that you have a lot of sadness that needs to be shared, and part of you believes that I get it.”
She glances at me, shoulders softening a tiny bit, then quickly retreats back behind her wall of hair.
“And two, that you have a lot of courage for seeking help when it’s so understandably difficult to show your pain to another person. I have a lot of respect for you for being here trying to work this through.”
We share a big sigh of breath.
“Do you believe me?”
“Can you peek at my face for a second? What do you see?”
She peeks. “I see concern. I see kindness. I see that you’re sad for me.”
“How is it to see that?”
“Good… Uncomfortable. But good.”
Another audible breath. She reaches for a tissue, blows her nose without trying to be quiet, and looks directly at me with cautious openness.
So much healing in such a small moment. A small moment that becomes expansive via two quintessential DEEP interventions. Let’s look at what they are.
Once we’re rooted in our three-pronged therapy foundation of 1) believing that people are seeking health and growth, rather than displaying pathology; 2) heading toward our fundamental goal of helping people gain access to their deepest true selves; and 3) accepting and making use of the basic truth that our sincere presence is the most important tool we bring to the table, the next questions we need to ask ourselves are: What do we do now that we’re here? And why do we do it?
That is, what ideas inform the interventions we use, as we use our presence to help people heal and gain access to their true selves?
The majority of our interventions are constructed from the two actions that informed all that I did in in the scene with my client:
Undoing aloneness. And reflecting value and worthiness.
Certainly these actions serve various purposes that we’ll discuss in future posts, purposes such as regulating emotion, expressing emotion, connecting in relationship, creating safety, building resilience, and more. You get the idea.
But these actions of undoing aloneness and reflecting worthiness can help guide every one of those other purposes.
Why these interventions? Where do they come from?
The short story is this: The DEEP therapeutic perspective about these intervention choices makes use of the attachment and interpersonal neurobiology idea that symptoms and problems in living emerge from having been left alone in the face of overwhelming and painful emotional experiences, and/or from not being reflected as valuable or worthy (or from being reflected as unworthy or defective).
In the moment I described above, my client was suffering pain from both of these experiences:
She was feeling profound sadness that seemed overwhelming to her because of its implicit tie to being abandoned with her sadness in childhood.
And she was feeling shame and unworthiness by anticipating my denigration of her for showing her basic human experience of sadness.
John Bowlby’s theory of internal working models clarifies this concept.
Bowlby theorized that repeated interactions with our caregivers generate knowledge about the world of relationships and self that get recorded in memory as internal working models. These internal working models are two specific types of implicit memory:
1) Internal working model of the world
Includes deep knowing who our attachment figures are, where they may be found, and how they may be expected to respond.
2) Internal working model of the self
Includes deep knowing of how acceptable or unacceptable we ourselves are in the eyes of our attachment figures.
On the structure of these two complementary working models, we build:
1) forecasts of how accessible and responsive attachment figures [and others in the future] are likely to be; AND
2) beliefs about whether or not we are worthy of being treated with respect and/or worthy of being loved.
When parents are unable to be accessible or responsive in a helpful way to their child’s experience and expression of emotion, the child is not only alone with the emotional experience without tools for regulation, she is also painfully out of synch with the much-needed-for-survival attachment figure. Repeated experiences of this type of anguished, unsought, unregulated aloneness generate implicit pain and insecurity in the internal working model of the world. This internalized model shows up as chaos or rigidity in the child’s (and then the adult’s) emotional world, such as the chaotic overwhelm that my client felt when she got a taste of the sadness she was beginning to explore in my presence.
When parents fail to reflect the goodness, lovability, and acceptability of a child, the child has no basis for knowing his intrinsic core value just for existing. Not receiving this type of reflection, and/or being reflected negatively instead, generates implicit pain and insecurity in the internal working model of the self. Wounds to the working model of the self lead to feelings of shame, defectiveness, or unworthiness, embedded deeply within the essence of the belief about the self. My client experienced this kind of core sense of shameful defectiveness within herself in reaction to her split-second implicit imagining that I would look upon her tears with disgust.
These internal working models can be hard to change because of the fact that they are most often outside of awareness (i.e. implicit), and also because they come into being to for the purpose of self-protection in the presence of the childhood attachment figure. But the good news is that the brain continues to grow and change throughout life, and these implicit working models can be shifted via new, healthy relationships (like therapy).
If we as therapists can tuck the idea of these two styles of implicit memories into the background knowledge we carry into the room with clients, we can use the concepts as touchstones that form the basis for our bedrock interventions.
That is, you can remind yourself that the meat of practicing attachment is embodied as:
– undoing the client’s unsought aloneness around emotional experience, and
– accurately reflecting the client’s inherent goodness and worthiness of care and respect.
You’ll find that interventions that arise from this practice of attachment are not techniquey, as they can be flexible and varied, based on attunement to the present-moment needs of the client. And you’ll find that undoing aloneness and reflecting worthiness fit hand-in-glove with our three-pronged foundation: These interventions emerge from our moment-to-moment presence with each individual client; they reinforce the belief that clients are seeking to heal and grow; and they yield gentle access to the client’s true self.
No matter what else might be needed, these interventions will build safety, trust, connection, and healing in heart and mind.
What are the go-to concepts that help you to know which direction to go in any given moment in a therapy session? How do these concepts give you a basis for choosing interventions? How can the concepts of internal working models that yield undoing aloneness and reflecting worthiness guide you in sessions with clients?
Bowlby, J. (1973). Attachment and loss: Vol. II, Separation: Anxiety and anger. New York: Basic Books.
Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York: Basic Books.
Ossefort-Russell, C. (2015). Training manual for DEEP skills and theory course. Unpublished training manual for course taught in Austin, TX.
Siegel, D. (2012). The developing mind (Second edition): How relationships and the brain interact to shape who we are. New York: The Guilford Press.
Wallin, D. (2007). Attachment in psychotherapy. New York: The Guildford Press.