Should Therapists Express Their Feelings?

Freud's Huge Error!

Featuring Matt May, MD

Today we touch base on a really important and highly controversial question: Should therapists express their feelings? Or remain blank slates, as Freud so strongly recommended.

We begin with a scholarly and really interesting (oxymoron?) piece that Matt wrote about Freud's own fear of sharing his feelings, and how that led to the huge mistake called psychoanalysis.

At the end of this piece, I will briefly summarize the podcast.

Matt's piece here

Matt began by describing a fascinating case of a woman who had a functional neurological disorder. She appeared, in other words, to be unable to walk, but her walking problem was entirely caused by her mind.

Often this type of problem is due to the "Hidden Emotion" phenomenon, where the patient is hiding some powerful feeling—from themselves and others—and then that feeling comes out indirectly, as some form of anxiety (very common) or even as a neurological problem, such as apparent paralysis in a limb.

Matt, can you briefly summarize your thinking on how her symptoms may have been due to suppressed anger?

During the session, the concept of anger came up, and the husband became agitated, and started pounding angrily on the desk. Clearly, of course, his wife was also terrified of him, one of the key dynamics in their dysfunctional marriage.

Matt was scared, and decided to say, "I feel scared right now." The man calmed down instantly. She, too, had been afraid of expressing her feelings.

Matt and Rhonda talked about effective and ineffective ways of expressing your feelings. Like everything else in the universe, "I Feel" statements are a two-edged sword.

What Matt said—"I feel scared"—was a human statement of vulnerability that did not threaten this many in any way. Matt's humanness allowed him to lower his defenses and open up as well.

But saying, "I feel controlled," is actually a hidden criticism of the other person, and it will nearly always trigger more aggression and anger.

They also discussed setting boundaries, another highly controversial topic, because much of the time, when therapists (or anyone) attempt to set boundaries, it comes across as an attempt to control the other person, to tell them what they can and cannot do, and that has a high probability of triggering more anger, and is an invitation to violate the annoying "limit" you are trying to set.

Matt described a common and frustrating dynamic: a woman who kept "forgetting" to do her psychotherapy homework, and instead kept chasing a man who treated her badly. Of course, her behavior caused him to become even more aggressive and abusive.

Matt: what was your point here? I didn't get it in my notes. Any help appreciated! You can be brief, as many words tends to intimidate me.

In contrast, a statement like "I'm feeling hurt right now," is vastly less powerful, since it is simply a gentle, non-aggressive way, of showing how you feel.

But by the same token, it is often vastly more powerful than attempts to set limits.

These are complicated topics, easily misunderstood. For more information, check out my book Feeling Good Together.

Warmly, David, Rhonda and Matt