Prevent panic: keep your room cool

Prevent clients from panicking by keeping your room cool. Overheating clients can misinterpret a rise in room temperature as the onset of a panic attack.

Panic occurs when benign physical sensations are interpreted as threatening, leading to a surge of adrenaline which exacerbates the sensations and the perceived threat (eg: a cramped chest muscle causes anxiety and tension, increasing the pain from the muscle and increasing the worry that a heart attack is occurring).

Anxious clients entering a hot consulting room can misinterpret the rise in temperature as a rise in their own anxiety levels. Fearing that they will lose control in front of you, they will produce more adrenaline, further raising their body temperature and beginning the vicious circle of a panic attack.

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Leave deduction to Sherlock Holmes

Deductions impress clients, but incorrect deductions can be disastrous. Deductive reasoning has its place in therapy, but only as a means of generating hypotheses on which you can work with clients.

A client who usually had bare arms arrived in a long-sleeved shirt on a hot day. When I noted the change, she showed me cuts on her wrists which had become infected. I asked her to consider getting the wounds treated and, at the end of the session, said how glad I was she’d decided to do so. She asked how I knew she’d made that decision and I pointed out that she’d rolled up her sleeves. She was impressed by my deductive abilities: I felt like Sherlock Holmes. I was an idiot.

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To see ourselves as clients see us

Therapists should be aware that clients may see them in a very different light. They should also be aware that these impressions are a matter of perspective and there may be fewer real differences than either therapist or client imagines.

Robert Burns wrote

Wad that God the giftie gie us
To see ourselves as others see us

In principle we all have such a gift (except perhaps people with autism, but that’s another discussion). In practice, this gift tends to be underused, especially in the consulting room.

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