Thread by @JonathanShedler

1/14 It's important as therapists to think carefully about language we use... whether it serves to facilitate or impede self-exploration & understanding. The word "stress," for example, can easily become a form of externalization. It implicitly locates the source of problem

2/14 "out there." People do not in fact experience "stress." It is not the name of an emotion. We experience sadness, grief, anger, anxiety, fear, agitation, guilt, resentment, dread, etc. Those are words that describe emotional experience. "Stress" does not. If we identify an

3/14 experience as "stress," leave it at that, and quickly turn to "strategies to manage stress," we are missing an opportunity to explore & better understand our patient's experience & the meanings it holds. At best, we miss an opportunity. At worst, we collude with our pt's

4/14 defenses against attending to and articulating difficult aspects of experience. It's a red flag for me as a teacher/supervisor when therapists speak of "strategies for managing stress." It *may* just be semantics, and the therapist's shorthand for the shared hard work of

5/14 exploring & putting words to difficult experience. But I have seen that it can also reflect a reluctance to look more deeply and engage our patients in looking more deeply, at complex, painful, & difficult thoughts/feelings. The danger is that the moment therapist & patient

6/14 frame their mutual task as "strategies for managing stress," those unwelcome & difficult aspects of experience becomes object rather than subject, to therapist and patient both. The feelings are implicitly viewed by both as something alien, unwelcome, and "other"—versus

7/14 valid & important & meaningful aspects of experience & of self to understand and integrate. The goal in therapy is always to expand range of thoughts/ feelings /experiences recognized as "self," and integrate them with the full range of other experiences understood as self—

8/14 never to contract or limit what can be perceived/experienced as self, or regard aspects of experience as "other." Increased capacity for emotional regulation comes from *putting words* to previously unarticulated aspects of experience & *integrating* those experiences in a

9/14 way that develops personal coherence & continuity. *That* is emotional regulation. Maybe some therapists who speak of "strategies for managing stress" mean all these things too, but it is not what I have usually observed in practice. The term "managing" implicitly

10/14 frames parts of self as "other" (object) versus subject.

A great deal is at stake here, far more than meets the eye, with respect to our view of human psychology, and how we understand our patients, ourselves, and the shared work of psychotherapy. To simply brush aside

11/14 these meanings and nuances, as if nothing of consequence were at stake, does violence to human experience and to the importance, seriousness, and dignity of the work of psychotherapy. To brush them aside to make some ideological or political point, or take one or another

12/14 ideological stand, does more violence still. The mindset of a true therapist is openness & curiosity to all aspects of experience, including & especially those that may initially seem alien or objectionable. "I am human, and I consider nothing that is human alien to me."

13/14 Those who share this view are my professional colleagues, my brothers and sisters. I recognize & acknowledge them as full colleagues, even where there are large areas of disagreement.

Those who seek to quickly silence or dismiss ideas that don't accord with their own, or

14/14 ridicule them before they have heard enough to even begin to understand, are not my professional colleagues. Silencing & othering are incompatible with the habits of mind of a psychotherapist. If they are psychologists or psychiatrists, they are that in name alone.