Follow The Pain

The paperback of the book, The First Kiss: Undoing the Intake Model and Igniting First Sessions in Psychotherapy is now available! 

The ebook from various retailers (Kindle, Apple, Kobo, etc.) with different reading formats is downloadable here.

Here’s another chapter from the book.

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Chapter 24. Follow the Pain

“The truth will set you free… But first it will hurt like hell.” 

~ First heard from a friend, Edwyn de Souza. Original source unknown.

The term “follow the pain” is borrowed from Leslie Greenberg’s work in emotion-focused therapy. He and co-author Jeanne Watson call it “developing a pain compass,” using it as an emotional tracking device.^⁠1⁠ Bruce Ecker, lead proponent of coherence therapy, says that once you find the pain spot, “Pitch a tent. Set up camp right there.”^⁠2

This is a distinctive feature in psychotherapy. It goes where no hairdresser, bartender, or even well-meaning family and friends would go. When others hear something painful, their instinctive reaction is to soothe or divert to another topic.

In the task of therapy, we are not to soothe too quickly, but rather to make room and deepen the experience of the complex layer of emotions. We needn’t be cold-hearted in the process, as we need to offer a healing presence as we “follow the pain.” This can be done in many ways without prematurely “bandaging it up,” such as providing empathic reflections, or even disclosing your emotional reactions. Implicitly, this can be done by slowing down the pace, lowering and deepening your voice, leaning forward to communicate presence and attentiveness. 

When we soothe too quickly, we shut the door. Especially in the first session, we want to welcome our client’s emotional world, as their inner life doesn’t get invited into their usual social realm often. 

There is a fine line between trauma and healing. We “follow the pain” because we facilitate its healing.

Notes:

¹ “Developing a pain compass,” see pp. 144-145 in Greenberg, L., & Watson, J. C. (2006). Emotion-focused therapy for depression. Washington, DC: APA.

² “Pitch a tent. Set up camp right there.” as cited on page 51 of Ecker, B., Ticic, R., & Hulley, L. (2012). 

Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. New  York: Routledge.