by Dr Wes Turner (Clinical Psychologist) and Samantha Butterworth (Psychologist)
Sometimes we can get thrown by clients in therapy when they say things like the below:
“What do you think I should do?”
… followed shortly by, “but I can’t do that.”
While this may seem contradictory, it’s really quite not. It’s rarely about what might be logical, and is more so about what the client is likely fearing. What it has historically felt like to let someone else steer. Or worse – to want something, to act upon it, and to then get punished, shamed, or abandoned. And it’s about what gets stirred for our clients when they feel this again in the room, with us as their therapists.
What can we do in these moments? When clients reach out to us and yet push us away in the same breath? When they ask us to decide, but feel controlled the moment we try to help them.
Autonomy Is Not the Same as Independence
Autonomy is not about doing it all alone. It is about being able to experience one’s own sensory signals and to follow them – without losing connection, being punished, abandoned, ridiculed, or engulfed.
A lot of people we work with want guidance yet hate being guided – they recoil. Not because they are being difficult or resistant, but because their nervous system registers this a potential attachment threat.
So when they ask, “what do you think I should do?”, what we are actually hearing is “Can I feel what I feel and still be safe with you? Can I disagree with you and not lose you? Can I want what I want and not get punished or shamed by you?”
Too Much or Not Enough
This is where we can often get stuck. We might lean in, try to help, but the client gets flooded. We may pull back, try to give space, but the client feels abandoned. Either way, the client loses their footing and we can feel stuck.
Even gentle questions or reflections can feel like pressure if the client is already struggling to determine where they end and other people begin. Their response might be to go blank, agree and disengage, reject the suggestion outright, or hand the entire process back to us.
These responses are not oppositional, but in fact are actually protective.
The Experience of Agency as Mistrusted, Misused, or Taken
Many clients have learned early on that having a preference or an impulse led to negative outcomes. They might have been mocked, ignored, yelled at, guilted, or put in a double bind. So they learnt to adapt by:
· Freezing.
· Complying.
· No longer asking.
· No longer choosing.
By the time they enter therapy, any movement towards autonomy within a relationship can feel foreign or terrifying. This is not resistance, it is their nervous system saying to them that things are not safe.
Slow Everything Down
The first step is not to help them decide, but to help them notice what is happening inside of them:
· What is the body doing?
· Is there a pull? A tightening? An urge to move or speak or run?
· Is there a collapse? A disappearance? A compulsion to fawn or flee?
We do not rush to interpret or reframe, but to instead slow things down to help them feel safe.
We may say things like:
· “Is it okay if we just sit with this a bit longer?”
· “I notice I want to say something. Can I check in with you how you are experiencing this?”
· “If something in you had a leaning, even a tiny preference, what would it be?”
When We Get Hooked
These moments can stir things up in us as therapists – our countertransference responses. We may want to help, we may want the client to move forward, we may want to say something that we think will help open things up. But more often than not, it is more appropriate for us to just notice our own impulses whilst remaining connected with the client.
We breathe, wait, and let go of trying to being “helpful”, and instead try to be present with them.
At times it may feel like we are doing nothing, but that “nothing” might be the first time the client has felt safe enough to sit with their own internal experience without someone else taking over or checking out.
Working With Clients Who May Experience Invitations as Demands (PDA)
For clients with a PDA profile or similar relational threat sensitivity, any invitation may land as a command. Even saying, “What would feel okay to eat for lunch?” may be too much. Their nervous system interprets this as a threat and their body says “No”.
Here, we must tread especially gently. We may ask things like:
· “If something felt less bad, what might it be?”
· “If you did not have to decide, but we just notice, what comes up for you?”
Fostering Autonomy
Our goal is to try to make it feel possible for our clients, maybe for the first time ever, that they can feel something, name it, and act upon it, without feeling threatened.
This doesn’t happen when we push, it happens when we stay present with them.
We are not here to direct their life, we are here to help them feel safe enough to take charge of their own lives.
Sometimes this means not immediately answering their questions. Sometimes this means catching our own urge to fix things. Sometimes this means doing “nothing” so that we can actually stay present with them.
More often than not, that is our work as therapists.
For further information on understanding and applying these concepts, feel free to contact us or reach out to info@mindsandhearts.net to make an appointment with Dr Wes Turner.