Leveraging the Will to Heal in Psychotherapy

Susan Warren Warshow

22 December, 2023

When does stuckness give way to change in therapy? How does a resisting client become a working partner? The key, of course, lies not in exerting pressure but rather in exploring the cost of old patterns and empowering a sense of choice. Susan Warren Warshow, psychotherapist, author and founder of Dynamic Emotion Focused Therapy, reflects on the painful intrapersonal and interpersonal consequences of repressing feelings – and how identifying these with compassion can help our clients leverage their healthy internal force.

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One of the most valuable teachings I’ve received is to move toward feelings that the client avoids. But hold on! Clients move away from feelings for good reason, fearing humiliation, rejection, and loss of control.

Several clients who have repeated the same patterns throughout their lives only to get the same painful results come to mind. As I contemplate resistance to change and wonder what will move the needle, I think about the power and potential leverage of the healthy force within an individual. How do we awaken this sleeping giant?

One client’s contemptuous facial expression, hardened jaw, and sharp tone revealed her fury at a family member who had openly ridiculed her at a holiday gathering. Her core instantly slumped when asked if she might name her feelings, and she exhaled deeply. She told me it felt like a rigid rod going through the middle of her body. Her chest and shoulder muscles squeezed together while she held her angry energy in a straight jacket. “Anger is bad!” she declared.

Carl Jung taught us that what we resist persists. Instead of forming a relationship with her feelings, my client deadened herself and shut out friends and family. She felt guilty about her explosiveness with her husband. Her resistance to allowing her rage and conflicted feelings to become conscious was massive. What could provide a counterweight?

Again and again, I have found that when we explicitly help people link repression to its painful consequences, while showing compassion, we can leverage change to occur.

Intrapersonal consequences of repressing feelings:

One man who instantly repressed his feelings woke up every morning with a piercing pain across his chest (severe muscle tightness). Another client had IBS symptoms whenever she suppressed rage. Another had migraine headaches just at those moments when someone dismissed or devalued her, as her mother had done.

Anxiety, shame, guilt, and self-protective strategies often accompany conflicted feelings, and these responses can affect the immune system, cause bodily distress, and damage the connections we need to be healthy. My clients’ symptoms reliably lessen with greater freedom to feel the full range of feelings. Most of our clients have not discovered the link between physical symptoms and repressed emotional states until the therapist brings this link to consciousness.

Interpersonal consequences of repressing feelings:

We cannot protect ourselves or meet our needs when we detach from our feelings. We may also struggle to experience connection. Some common signs that this dynamic is at play for our clients are when family members or friends say things like:

“You know, I can’t feel close to you.”

“I don’t know who you are.”

“You got so upset. It seemed out of proportion.”

“Why did you pull away from me so suddenly? I thought we were friends.”

“I can’t relax with you. You seem tense all the time.”

More often, those close to us may not communicate at all. A client may feel increasingly alone and unseen and not understand why.

Whether drawing attention to intrapersonal or interpersonal consequences, we must do this with compassion to reduce shame and awaken the will to care for ourselves actively.

I’ll end with an example of my attempt to activate the leverage of the healthy force over one man’s firm belief that he could trust no one. A brilliant writer, he had all the tools to articulate his reasons why people cannot be trusted. However, his distrust painted him into an unbearably lonely corner. I needed to interrupt his stream of rationalisations so he could see his dilemma and mobilise his healthy force to intervene:

“Richard, you have many reasons to support your distrust of others, including me. I’m also imagining your mind devalues you. At the same time, I’m hearing your excruciating sense of aloneness and your longing to feel connected, especially to your sons and your wife. You describe awful feelings of emptiness, which happen when you unconsciously block a relationship with yourself.

“Can we assume your detachment attempts to protect you, and can we feel compassion for the pain it unintentionally brings you, your wife, and your sons?

“I suggest we remove the pressure to ‘connect’ or ‘feel’ and aim to reveal the truth of what is inside you with as little judgment as possible. Would you be willing to work toward distrusting your distrust? It will separate you from your family, yourself, and me. Could we focus beyond the intellectual mind so we can notice your feelings and bodily sensations? For example, I saw sadness in your eyes as you were talking about your sons. Can we follow that feeling?”

Richard had thought himself to be a stony person, devoid of feelings. But the statue was weeping, and so the statue must be alive. He was a human with longings and desires, and he did not want his family to suffer the deprivation that he took for granted. His despair shifted when he agreed to work with me to practice encouraging his feelings instead of pronouncing them dead and meaningless. He would reclaim his ability to feel.

Susan Warren Warshow
Susan Warren Warshow is the founder of the Dynamic Emotion Focused Therapy (DEFT) Institute, which offers a monthly training programme, webinar series and special events. She is the author of A Therapist’s Handbook to Dissolve Shame and Defense: Master the Moment. Her second book, The Practice of Dynamic Emotion Focused Therapy: A Shame Sensitive Workbook, will also be released by Routledge. She is a Licensed Clinical Social Worker, Board Certified Diplomate, and a Licensed Marriage and Family Therapist. She is a Certified IEDTA Teacher/Supervisor. She has published several articles in professional journals and has a private practice treating individuals and couples and offers clinical supervision. Susan also presents at conferences and workshops nationally and internationally, and has been a guest lecturer. Formerly, she was a supervisor and Coordinator of Continuing Education at the Department of Psychiatry at Northridge Hospital. She produced over 100 public presentations on child abuse and neglect in L.A. County and was media director for L.A.'s first child abuse hotline. To find out more about Susan's work, including recent interviews and current trainings, visit www.deftinstitute.com.

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