Not every emotional distress requires treatment and not every person will ask for help. So what is emotional therapy, or psychotherapy? And what is the therapist’s role? There are many different methods and approaches,but they all share a common denominator which I will describe in detail.

For What Emotional Conditions Must Help Be Sought?

From babyhood onward, we pass through a variety of different experiences – some uplifting, such as joy, inspiration, and enthusiasm; and others stormy, such as anger, sadness and more. The negative emotions require sensitivity and even effort from the people close to us. Yet, such support is not always available at the right moment. Therefore, already in early childhood, we face a conflict inside ourselves between our emotions and the environment’s reaction. A negative emotion in childhood, if met by no appropriate response from the environment, arouses a fear of abandonment, triggers rejection, and undermines the feeling of security. Therefore, we employ defense mechanisms that will enable us to bridge that misalignment and maintain a sense of security and of belonging to the close environment.

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For example, in a situation where we feel vulnerable and angry because our needs/desires have not been satisfied, we will choose to show the emotion befitting our understanding of the environment. If an expression of anger generates rejection and withdrawal, then a feeling of helplessness and a fear of rejection will be added on top of our anger. In such a case, we will find a mechanism that, on the one hand, will protect us from being hurt and, on the other hand, will maintain our feeling of belonging; for instance, repressing the emotion, waiving our wishes, manipulating the environment, or taking responsibility for the environment – all for the sake of inner balance.

Life goes on, new experiences also bring emotional storms and difficulties, but we continue employing the same defense mechanisms. If the feeling of control over the environment survives, then in most cases we will opt to disregard the difficulty and will not confront it lest we awaken that paralyzing fear etched in our memory.

The complexity of the situation revolves around the simple fact that the immediate environment expands and necessarily changes. The same defense mechanisms that helped us to deal with specific people, arouse totally different reactions in others. When the environment’s reaction is hostile despite the defense mechanisms, we have no alternative. The situation requires us to cope: to take a risk, make an effort, and step out of our comfort zone, in order to put control and balance back into our life.

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Of course, there is nonetheless a choice to be made. Obviously, any coping provides a feeling of accomplishment, raises self-esteem, and increases the ability to affect reality more appropriately. However, it is just as possible to choose, instead, to evade the environment that does not allow the same dynamic which we’ve been accustomed to since childhood. The sense of belonging will be maintained, and we will not need to cope or to exert ourselves, although we will pay a price in self-esteem.

Let’s return to the option of coping, and with it the sense of achievement which creates a new dynamic in the face of reality. The change finds practical expression in the realization of our true aspirations and desires. Nevertheless, the new dynamic may contradict the deeply etched defense mechanisms in our system. An inner conflict arises! When we give up those mechanisms that we created in our childhood, instantly we perceive a danger of isolation and abandonment, even if it is imaginary and does not apply here and now. Despite that perception, any attempt to preserve a former dynamic will fail to provide an appropriate solution to negative emotions and will even harm our self-image, as it undermines the ability to fully express the inner aspirations that emerge as a result of the change. The conflict gradually creates increased distress since we have no ability to compensate for it. At this point, the search for help begins.

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The Therapeutic Process

As stated, the change has already occurred although it was nothing we noticed or defined. The role of the emotional distress that we experience is to force us to adjust our inner structures as well for a boost of our self- image.

So what does the treatment involve? The purpose of the treatment is, first and foremost, to define the inner conflict and reveal the inner change that we have undergone. Then, the question is which inner mechanisms are no longer appropriate for us. We must identify the defense mechanism in real time, and know which triggers or situations activate it, in order to prevent it from operating automatically. Moreover, we want to pay attention to the inner discourse that is coupled with the need for self-defense; that is, the things we told ourselves while embracing the mechanism in childhood.

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For instance, when a young man is treated thoughtlessly, he responds by turning inward and avoiding any interaction with others. This response served its purpose well during his childhood, and it even found justification in an internal explanation portraying him as weak and unfit for confrontations. But today, after many experiences and after acquiring the tools for demanding fair treatment from people, he doesn’t have to shield himself. Yet, he has a problem. When he faces similar thoughtlessness towards himself, and desires not to succumb to the defense mechanism, he will experience great fear that originates in his childhood. However, if he reacts by turning inward, then instead of maintaining an inner balance, he will be undermined even more by regret and helplessness. The reason is that he already knows, from experience, that it is possible to cope, so that as soon as he succumbs to the familiar automatic reaction, the old idea that he is weak emerges and counteracts the inner strength that had formed.

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In his case, we’ve identified the reason for his initially choosing, in childhood, to react defensively, as well the internal discourse accompanying him since then. When he realizes what factors were influencing him, considers them from a mature perspective, and resolves the contradiction between the internal discourse of his childhood and the current situation, the automatic reaction loses power. The outcome, from his point of view, is in evidence when he encounters unpleasant situations and now can choose how to respond. In situations where turning inward is not appropriate, he can choose a wise response befitting the circumstances (rather than responding automatically) without evoking the fear of abandonment, because his internal discourse is not influenced by his childhood experiences. We have reinstated his sense of control and his influence over reality.

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The Element of Choice

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Together with the emotional distress that indicates change, we encounter another main element that is necessary in every therapeutic process. This element depends entirely on the person himself - an inner choice to appreciate and love oneself. Neither the treatment framework nor the environment can influence that inner choice; they can only require it. Moreover, if any external actor attempts to persuade or cause the person to choose that love, it allows the responsibility to be attributed to someone other than the individual and thus neutralizes the need for self-searching. In the absence of internal reasons that require self-esteem and love, the choice is no more than a meaningless mantra.

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Choosing love and self-esteem has no importance as long as the person experiences a situation of belonging, balance, and control. It comes to the fore when self-esteem increases after life experiences and after coping, when the previous structures are no longer suitable. The choice is between on the one hand appreciating and loving oneself – continuing to cope and strive, risking uncertainty and vulnerability, engaging in confrontation and demanding to be loved as a winner; or on the other hand deciding internally not to love oneself, but rather to transfer to others the responsibility for one’s quality of life, to continue activating the same defense mechanisms, and even to strengthen one’s lack of self-esteem in order to justify the failure to cope. All this is in the light of a very strong inner awareness that one has already advanced a few steps and thus possesses a capability and an inner strength.

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Why would one ever choose not to love oneself and not to cope? What benefit comes from lacking self-esteem? Only a false sense of control.

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Last, But Not Least – the Therapist

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Everyone’s inner world is unique and complex. Discovering the inner reasons for distress in another person is a very complicated task. Therefore, we employ diverse methods, approaches, and techniques that enable us to approach those extreme experiences gently and in an unthreatening manner combined with full confidence that the solution is within reach and that the favorable change is possible and available.

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However, this is not the main aspect. The therapist’s main role is to take an interest and provide total empathy. Merely understanding the patient’s emotional situation is not at all sufficient, the therapist needs to discover the maximum potential, the best version of that person, on the other side of the difficulty or distress. This is a necessary condition for creating a protective atmosphere. The patient needs to feel safe enough to waive the defenses and be willing to look inward. Then the patient will be able to confront emotions that were previously very frightening and to permit a process to create a change in inner perspective and in ways of thinking.

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The therapist’s own personal coping experiences must be brought to bear. Only thus can the therapist provide the patient with the necessary sense of grounding and safety and counteract the emotions that accompany distress, including helplessness, despair, and reluctance. If the therapist lacks inner experience in coping, there will be distancing and hesitation regarding whether a solution can be found to the distress. Needless to say, the therapeutic process would thus be hindered and the patient’s feeling of helplessness could increase.

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The common denominator for a healing emotional process that results in a significant outcome is total empathy and ability to take the distress in, combined with the demand that the patient chooses self-love and self-esteem.

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