Creating Relational Safety in an Emotional Storm
“The ability to offer safe sanctuary of presence is central to treating trauma”
As a Family Therapist and Psychologist, I am deeply aware of the importance of the therapeutic relationship and critical need for a felt sense of safety. I am also aware that as a Family Therapist the emotional tone, and sometimes emotional storm, in the room can intensify when there is more than one person in a therapy session or meeting. At these times it becomes critical for a Therapist to manage themself in the relationship – to be aware of all the ways that emotional experience and functioning can impact professional judgment and the service offered. Evidence indicates that when emotions run high ethical decision making can suffer (Shaw, 2015) and so developing the capacity for self-awareness, emotional regulation, anxiety management and attunement is as critical for therapists as it is beneficial for those we work with. Mindful presence offers protection for the therapist from their own reactivity through greater awareness and a better understanding of internal processes.
These days most Therapists are familiar with Mindfulness and most people have at least heard of Mindfulness – even if they don’t fully understand what it involves or how it can be helpful. This ancient concept might have its roots in Buddhism but it is now accepted as “a universal, innate human capacity that transcends religion and culture” (Shapiro, 2020). The idea is that we can bring our attention fully into the present by paying attention with openness, curiosity, flexibility, kindness, and a non-judgmental attitude and that this can assist in handling painful feelings, stress, cravings, and negative thoughts, and increase engagement, concentration and focus.
Neuroscience helps by giving some understanding of how this works e.g., the importance of the role of an attitude of kindness in mindfulness practice. The stress response triggers sympathetic neurotransmitters (adrenalin, cortisol) creating a stressed chemical environment that negatively shapes thought, emotion, and sensation. An attitude of kindness on the other hand activates a relaxation response in the brain triggering parasympathetic neurotransmitters (acetylcholine, endorphins, oxytocin) which positively shape thought, emotions, and sensation. It’s amazing to think that approaching a difficult situation with an attitude of kindness can make a positive impact on multiple levels.
The benefits of Mindfulness for our clients are well known and there is an increasing body of research in this area for a variety of presenting problems and difficulties. What is also great to see is the application of Mindfulness to Therapists themselves with the understanding that Mindfulness can help develop therapeutic presence.
What is a therapeutic presence and how is it helpful? Therapeutic presence is best understood as a shift in focus from ‘doing’ in therapy to ‘being’. It involves availability and openness to all aspects of a client’s experience, openness to one’s own experience in being with a client, and the capacity to respond to the client from this experience (Geller and Greenberg, 2002). In her book “The Heart of Trauma” Bonnie Badenoch notes “...the difference between using interventions and following the process unfolding in the space between our patients and us lies at the heart of the matter”.
How is it that a mindful therapeutic presence can facilitate being present and the creation and amplification of the felt sense of safety that is so important in the therapeutic relationship? Mindfulness facilitates empathy in part by reducing stress. As stress decreases, we are able to move out of our emotional brains back into our thinking brains and to integrate our thoughts and feelings in the service of the client…and empathy increases. Mindfulness also creates increasing capacity for other empathy through increasing our own self-compassion and increases acceptance whilst also decreasing defense and judgment through releasing our identification with our own personal subjective experience (McCollum & Gerhart, 2010).
Briere (2013) also lets us know that therapist mindfulness assists in maintaining attunement to the client, and that attunement combined with compassion results in relational activation – an engagement of psychological and neurobiological systems that encourages openness and connection, reduces expectations of interpersonal danger, and increases wellbeing. Attunement enables authentic connection, and as described by Daniel Seigel in ‘The Mindful Therapist’, is more than therapeutic presence, involving also focused attention and clear perception – all three aspects of the therapeutic relationship that are enhanced by Mindfulness.
And so improving Mindfulness makes sense - to focus attention in an alert, accepting, compassionate way to increase the quality of the relationship, and increase the value of the therapeutic service offered.
How will you use Mindfulness in your practice?
Dr Leonie White
Clinical Family Therapist & Psychologist
Badenoch, B. (2018). The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships. WW Norton and Company: New York.
Brier, J. (2013). Mindfulness, Insight and Trauma Therapy. In In Mindfulness and Psychotherapy (Germer, C., Siegel, D. & Fulton, P. eds). The Guildord Press: New York.
Geller and Greenberg (2002). Therapeutic presence: Therapists’ experience of presence in the psychotherapy encounter in psychotherapy. Person Centered and Experiential Psychotherapies, 1(1 – 2), 71 – 86.
McCollum & Gerhart (2010). Using mindfulness meditation to teach beginning therapists therapeutic presence: A qualitative study. Journal of Marital and Family Therapy, 36(3), 347 – 360.
Seigel, D. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration. WW Norton and Company: New York.
Shapiro, S. (2020). Good Morning, I Love You: Mindfulness + Self-Compassion Practices to Rewire Your Brain for Calm, Clarity and Joy. Sounds True: Boulder Colorado.