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Writer's pictureJD Reisinger

Presence In The Therapy Space

The dance between spirituality and therapeutic healing has always been an interesting line of curiosity and inquiry for me. What works and what doesn’t in therapy? What helps client’s heal?


I recall a time I was in an Aikido class, a Japanese martial art, with a now fellow colleague. As we trained in the early morning, like we always did weekly during my master’s program to become a clinical mental health counselor, I remember complaining about the academic load and the massive amounts of cognitive studying we were doing in the program for a career that was so inherently relational. My colleague practices sensorimotor psychotherapy, a practice focused on making contact with the body and moving past cognitive ways of engaging therapeutically. In our conversation he mentioned to me: “You know, you would learn more about counseling by coming to these aikido classes than you would going to your college courses”. I remember feeling angry hearing this. His assertion felt ignorant of science and data, and it hurt knowing how much I was paying for those college classes compared to the martial arts class. When I look back now, graduate education was invaluable as I received a necessary dose of professionalism and understanding of core components of the counseling profession.

 

However, it felt like all of my formal education was nowhere to be seen when I finally had to sit down across from another alive human being. There is a specific type of pain that can show up for counselors, if you really care about your work, when you “miss” connecting with your clients. This doesn’t happen to me often, but when it does it hurts. It really absolutely hurts. There are times when a client leaves and they “hurt” because of the work they are doing, but there is usually a positive feeling and connection between me and the client when this occurs. In contrast, there have been a handful of times where the client leaves with a sense of unsettledness that has nothing to do with the work we did. I take this as a sign that I have usually “missed” something with the client. 


I have a client in which we usually end with a large and deep sense of human to human connection, of being seen. There was a session that did not end in this way. The session ended with a feeling of slight disconnect, as if the session wasn’t as helpful as it could be. My client seemed to have a frustrated, disconnected, unseen feeling in their system. I could tell by the way she wasn’t as open, engaged, or enthusiastic as usual. I knew exactly why. I leaned so far into helping her solve problems that I wasn’t receiving the client's heart where she was at in the moment. My words spoke louder than hers, and in that reality a relational rupture occurred. The client felt unseen.  Although she and I usually consensually go into these ways of relating where I provide a lot of psychoeducation, that day it wasn’t needed so much. Ever since that moment of missing my client, I have had a conscious foot on the brake of providing psychoeducation. I pay attention to it more and instead, I practice receiving her as she is right now today.  


This intersection of intellectual knowing, certainty (from aggressively holding onto facts and not being open to other’s views, and “what works” (what leads to healing and wellbeing) with clients is an important area to scavenge as a counselor for answers. This intersection brought me directly into my heart and into my mind. What I found getting in the way of my success with clients was a basic operating system, a way of trying to change, fix, and control - and what I would find actually helped was a way of allowing, accepting, and collaborating with. This is a struggle, because clients come to us with problems and we are, after all, the professionals. It creates an interesting experience of needing to know what to do, which puts our solution-focused components of thinking at the forefront. There are problems, big problems, and also big emotions of pain, hurt, and confusion that plague our client’s lives. What should we do when someone is sinking? We often try to ease the pain, organize the problem, and turn that frown upside down! However, our hearts are not so clearly organized and these attempts to help can become harmful aggressions on the client’s entire being. 


The difference between learning about counseling and succeeding in counseling (as a therapist) is like swimming. You can learn about swimming all day long from the safety of your room, but when it comes time to dip your toes in the wintery cold water, you may feel unprepared for such chaos and well, humanity. How do you know where to go, what information is important, and how do you move to create wellbeing instead of greater stuckness? 


What I am discussing here in the paper so far is intellectual knowing, organizing experience, having and problem solving and it is what I would call “the act of leading”. A person has submitted themselves and is looking for guidance, or well, counsel. Our worldview, education, and knowledge about wellbeing will guide where we focus our clients and the session. As graduate education taught me, we need to have strong cognitive frameworks, because we need to make sure we can guide our client’s towards the highest forms of wellbeing possible. This is the realm of knowledge, facts, and evidence based practices. As mentioned above, this leading is not the only mechanism of the therapeutic experience.


The other component to the therapeutic experience is “the act of receiving” or how we “follow” or “accept” a client’s experience. You can lead clients to see how they are wrong and you are right, but what do you do when someone shares their deepest heartache with you? Provide a quick solution, or an open listening heart? When emotions get involved, we may not even notice we are leading, but instead we may say “I am just trying to help”. A client who shares “It is hard for me to get out of the bed in the morning” may need to be met with a listening ear, open heart, and empathic response such as “Yeah… I hear you!” We also could see they are having  a problem with getting out of bed, quickly analyze it as a motivation problem, and tell the client to start thinking about it differently: “But don’t you realize there are so many bright, beautiful, and wonderful things you’re missing out on by sitting in your bed for so long!” Maybe this person already knows that, and they just need to complain about it. It is a fact that we need emotional clarity to also aid our rational clarity, and that these things compliment each other, not diminish the other’s effectiveness. 


In the example above, the therapist not only organizes and leads the session, but is also a beacon that radiates energy that affects the therapeutic alliance and the client’s understanding of themselves. The warmth and acceptance of a person’s statement may communicate to them that “it’s okay to not be okay”, and in turn they may have a newfound sense of resiliency from accepting and leaning into this fact. Therefore, while our intellectual Information can lead a conversation cognitively to a positive direction, our nervous system will influence our client’s transformation and healing on a deeper embodied level. Our nervous system and the way it is held is directly related to presence. When we are present, our minds are focused on what is at hand. We have a less likely chance of wandering off into abstract concepts that we find important, leaving our clients behind in the dirt of their most vulnerable challenges. Presence helps us pay attention to the nuances in our client’s voice, body, and energy. In this way, presence leads to greater receptivity, because we are focused on what is occurring versus being obsessed with our doing. 


Holding our bodies in a state of presence communicates meaning, feeling, and our position relationally to what is occurring in the environment. It is felt! 


When I am present, calm, and open to my environment, what information is being conveyed? The information of “It is okay to do nothing right now”, “It is okay to be yourself”, “I have zero expectations of you”, “You are unique and amazing as you are”. In stillness, in presence, we have the opportunity to convey deep information that our heart needs to hear. How often do you sit in a room with someone who is completely comfortable within themselves? What does it feel like to be in that space? How much do you laugh and feel enlivened and empowered? This too is a way of guiding our souls and nervous systems towards greater wellbeing. 


I remember falling in love with my now girlfriend who is also a counselor. I remember when I would first talk to her about my life. It was strange how I could ramble on and on, and it didn’t feel like I was losing her attention. She was completely present, and she understood what I was saying because of how present she was. The very act of how present she was to me created such a deep feeling of being heard and seen. Clearly, I think a lot and deeply so, and she was able to meet that part of me without judgment or shutting me down. I have had heartache in my life from not being able to share so full heartedly, and by being in her presence when I was  sharing myself, I felt like it was healing me and providing me a missing experience for the many times I longed to be heard and understood. I have had many counselors who have embodied this presence to me in moments and I am forever grateful for it. This skill  is meaningful because it is relational and it is at the heart of connection. 


95% of communication is nonverbal, and what we know  is a small component in comparison to how we hold our knowing in our bodies as clinicians. What we feel in our nervous system is communicated deeply and very loudly in the intimacy of an hour session with another person. How we feel on a cellular level every second of the session has an impact. 


I can pay tens of thousands of dollars for a graduate education to tell me how to diagnose mental illness and create treatment plans, but where can I build this capacity to be receptive and present within the heart and nuance of other’s lives? We all know how to lead more by gaining more information, but we as humans struggle with being deep in our receptivity. In what ways do you deepen your embodiment to convey the healthy nervous system that we all seek to have in our lives? 


Presence isn’t defined by any characteristics or state. However, I think it is the result of a single-minded intentional commitment towards engagement. The byproduct is then a feeling of presence, of being present with. When we have the intention (or subtle action) of being committed to the moment, we are present. When we are present, we are more engaging with what is occurring and in that we receive what is happening beyond our own little brains. 


Presence is a key component to healing because it can change the way we relate to our mind, energy, and environment. Many counselors relate primarily  on a cognitive level and usually feel lost any time the engagement runs off the script of what should be happening based on their evidence-based treatment plan. This limited capacity is usually counteracted with a form of aggression, where the counselor has to regain balance by being correct or right again. They perpetually keep the client sick in their own mind so they can continue to lead, which creates many problems. 


In my experience, we humans can inherently use our mind and energy in unwholesome ways, but with training and presence this doesn’t have to be true. It may be rare or weird to say, but I genuinely enjoy every single second of the therapeutic process. Through cultivating a receptive presence, I feel a constant state of enjoyment of my environment, I feel I have a calm state of being, and because I feel little pressure to force anything to occur, I can radiate constant acceptance to my clients. I oftentimes wonder what I look like in my client’s eyes, but I know it probably looks like a person who is consistently smiling at them (at least energetically). 


Not only does receptive presence change the information we give to our clients, but it can also deeply change the information we receive from our clients. This “leading information-based” component of mind is so quick to categorize every striata of our experience. It quickly leads to bias (implicit or explicit), judgment, non-acceptance, other-ness, and lacking interest in what is going on within our client’s worldview - it can be incredibly ego-centric at times. It is so important to know that with receptive presence, the information we receive about our environment can shift. Instead of seeing a prickly and annoying client who keeps complaining, we can see their heart, we can see their sincere struggle, and we can enjoy the process. We can experience a form of delight even when things are not easy. We can be in a state of enjoyment while also being deeply connected to our client’s struggles. When our mind sees joy, we do not need to push things away. When we constantly see our client’s wholeness, our perspective of “what is wrong” and “what needs to happen” loosens up. We can sit with groundedness, and move only with what needs to be moved with. We can stay strong when clients try to manipulate or put pressure on the counselor, and even enjoy it too. 


When we don’t need to defend ourselves, and I am not saying I am perfect at this either - most definitely not - we can then respond with more curiosity. This leads to my favorite type of counseling, which is called “state-dependent learning”. Instead of teaching clients to do things when they get angry, we engage with our client’s anger in session. Not only do we engage, but we go into it, we explore it, and we find ways of moving with the aliveness of our nervous systems in the moment. In this way, the client gains knowledge and mastery that they now know and feel in their bones. 


It is funny to me now, because I can see how right my colleague was at the time. Information about the profession and what I learned during my master’s program was invaluable and continues to serve me every single day. As I mentioned, I believe intellectual frameworks are helpful and we need them. Try and sit in presence only and you will have no words to share with people who are suffering. We must lead with frameworks, and we must also learn how to be present, to orient ourselves towards receiving. I didn’t know my colleague would be so right, but aikido seems to also study this line of leading while following, or expressing while receiving. There is a way that we are expressing while we are receiving and a way in which we are receiving when we are expressing ourselves. Fortunately, it seems like aikido, the training of presence, and counseling seem to intersect on these mechanisms of life.


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