The Therapy of Felt Feelings

Some of you might get the feeling that I have been offering a caricature of today’s therapy. After all, I occasionally present the wisdom of advice columnists as a manifestation of the state of today’s therapy culture. In truth, I more often prefer the letters to the advice, largely because they offer an unadulterated view of what is happening in people’s lives.

For many therapists today the experience of online therapy, via Skype or its equivalent, is a daunting challenge. Somehow the interposition of a screen breaks down the bonds of intimacy that are supposed to exist between patient and therapist. For therapist Lori Gottlieb, a best selling author and advice columnist, therapy is all about “felt feelings.” So she says in a Washington Post column. BTW, what would unfelt feelings be?

And you thought that I was caricaturing therapy when I made fun of New York Magazine advice columnist Ask Polly and her endless whining about feeling your feelings. After all, what else would you do with your feelings? 

In any event, all the talk about feeling your feelings and about felt feelings is, dare I say, girl talk. It has come to infest the therapy world, to the point that it has turned large numbers of people off of therapy. Surely, it's good for the coaching business.

Why do you need years worth of professional training to feel feelings, or better to feel felt feelings? The trouble is, you don’t. You cannot earn a Ph.D. in empathy-- at least, not now you can’t-- and besides, empathy is not going to help anyone anyway. If your patient feels hopeless and you feel his hopelessness, what exactly has either of you gained?

At a time when women are more likely to work outside of the home, why mire them in their inner emotional spaces? Trust me, out there in the business world, no one really cares about how you feel. And no one cares about whether you feel your feelings. If you want to alienate women from their work, you could not do better than this form of intimacy mongering. 

Therapy is not or should not be about talking things over, as though you were sitting in someone’s living room. It ought to be work. It ought to be a job. It ought to aim at working on problems, to the point of solving them. It is not about talking things over-- because talking things over suggests that you do not want to work on them, but that you want to wallow in them.

In any event, therapist Gottlieb seems to be looking for intimacy in her therapy sessions. Which is precisely what she should not be looking for. Working together to solve a problem precludes intimacy. Or, at least, it should. Doesn't she understand the more modern usage of the word "intimacy?" Apparently, not.

Consider her words:

What I meant was that online therapy seemed to go against the core of what I do as a therapist, which is to be present, literally and figuratively, with my patients. It’s not just the words people say or even the visual cues that therapists notice in person — the foot that shakes, the quivering lower lip, the eyes narrowing in anger. Beyond hearing and seeing, there’s the energy in the room, the being together in a shared space with no distractions, the mutual carrying of silences in the few feet between therapist and patient — all of which contribute to the patient’s experience of “feeling felt.” You lose that ineffable dimension when you aren’t sharing the same physical space, which is why a colleague once said that screen-to-screen is like “doing therapy with a condom on.”

That last is an especially lame metaphor. Precisely what kind of therapy was he doing? Why would he need to use a condom in therapy? Of course, he meant that it was like having sex with a condom on, but don’t you think that he ought to have gotten over the notion that therapy is a mind fuck?

Patients should not be going to therapy in order to feel felt. They ought to be there to forge a professional working relationship. And that requires formality and distance and propriety. Intimacy has no place in the therapist’s office.

Anyway, apparently Gottlieb’s patients do not have the option or the good grace to do their online sessions from a more decorous space. Some call from the restroom. Some are surrounded by family and friends and pets:

In search of privacy, people were talking to me from closets and cars, laundry rooms and bathrooms. In training, therapists are taught to “meet patients where they are,” but now the phrase took on new meaning. I heard kids arguing about screen time; watched cats jump over patients’ keyboards; saw spouses popping their heads in to ask a question and tried to tune out roommates talking loudly on their own calls in the background. It was the opposite of the sanctuary of the therapy room.

Of course, the therapy room is not a sanctuary. It is not even a room. It is an office. It’s not that difficult to understand. And yet, Gottlieb is happy to have found intimacy-- a word that, in today’s vernacular, does not really relate to felt feelings.

But by the end of the day, instead of feeling distanced from my patients, I was surprised to find that I felt closer to them. Online therapy, it turns out, provides a sense of intimacy I hadn’t anticipated.

Gottlieb gets it that the therapist’s office is not a space where intimacy should be at issue. But, she has chosen to conduct her sessions from her bedroom, of all places. And she thinks it more honest not to hide the fact that the space is evoking images of... who knows what?

Would you not have imagined that a woman who seems to have a thriving practice, who has written a best selling book, and who writes a magazine column would be able to afford to rent an office space:

A typical therapist’s office, no matter how welcoming we try to make it, is still a professional space: couch, therapist chair, diplomas or abstract art on the walls, therapy-related books on the shelf and the conspicuous absence of anything that might reveal a clinician’s personal life. But to me, it seemed almost silly to try to curate a spot like this in what was clearly my bedroom. Even putting a blank wall behind me felt disingenuous, a way of pretending that I wasn’t sitting in my home just like everyone else.

Whatever does it mean to invite your patients into your bedroom? Am I the only one who finds this bizarre?

Letting go might be easier while wrapped in a cozy blanket on your old armchair, sipping tea from your favorite mug. We therapists try to make our offices feel like safe spaces, but the safest space might actually be the one our patients have created for themselves: their turf, not ours.

Offices are not and should not be safe spaces. Is your accountant’s office a safe space? Is your lawyer's office a safe space? Or is it designed for a specific type of business activity? 

Now, Gottlieb tries to justify the fact that a patient was calling her while sitting on a toilet, because she imagines that it has provided access to a dazzling insight. Tell me how dazzled this makes you feel:

One man who conducted his sessions from his toilet seat shared that being there reminded him of his childhood, when he would escape to the bathroom to avoid hearing his parents fight. He said he retreats there now when he senses his wife is angry as a way to avoid talking to her about it, something I may never have learned had he not been hiding in the bathroom for our sessions.

Excavating the past, getting lost in the past, ignoring present situations, failing to work on current problems… is that what therapy has become? If so, it explains why therapy is going out of fashion. And why these pretend insights rarely produce any serious benefit.

Anyway, Gottlieb ends up by filing it under the perfectly mindless notion of a shared humanity. All human beings share humanity. It’s in the DNA. To think that you have actually accomplished something, provided a material advantage to a patient for feeling that you are both human beings-- why exactly do you need years of professional training for that:

But I’m grateful for these remote sessions because they’ve been both an illuminator and an equalizer, breaking down the facades we all construct and highlighting our shared humanity. And in that sense, maybe I’d call them therapy after all.