On Feeling Uncomfortable in Psychotherapy (and Life!)
As a trauma therapist in Oakland and Berkeley, California, I work with a lot of clients who feel far more than their fair share of discomfort. And going to therapy is about soothing that discomfort and walking out the door feeling amazing, right? Well...
Life is inherently uncomfortable, painful, and full of grief, frustrations, and disappointments. Even in a utopian, egalitarian world free of injustices, we will stub our toes, get headaches, be disappointed by people, and misunderstand each other. Being uncomfortable is part of being human! And growing resilience to tolerate the hard parts of life increases overall life satisfaction.
A Therapist Can Ice Your Knee, But Hopefully, They Aren’t Ignoring The Root of Your Injury
Looks like a torn meniscus…
Individuals who have experienced trauma in the past are often hyper-aware of potential threats or danger. This heightened sensitivity can lead clients to interpret any form of discomfort as a sign of imminent danger, triggering their fight-or-flight response. Trauma survivors often develop hypervigilance as a coping mechanism to protect themselves from harm. This constant alertness can cause them to perceive ordinary situations or minor discomforts as threatening.
Further, cognitive biases such as confirmation bias and negativity bias can influence how individuals interpret and process information. Someone who has experienced trauma may be more prone to interpreting ambiguous or uncomfortable situations in a negative light, reinforcing their perception of lack of safety.
Seeking comfort may function as a way to ward off feelings of vulnerability or existential angst by seeking reassurance and security from external sources. That’s good, right? Well, no, it’s avoidance of the real suffering of the world. Existential angst, while uncomfortable, can be a catalyst for profound self-exploration and introspection. By embracing vulnerability and confronting existential questions, individuals have the potential to gain deeper insights into their values, beliefs, and purpose in life. Instead of seeking external sources of security, they can cultivate inner resilience and develop coping mechanisms that are rooted in self-awareness and authenticity. Grappling with the inherent uncertainties of life, they develop a greater capacity to tolerate ambiguity and navigate complex challenges with courage and integrity. In relationships, the ability to tolerate discomfort fosters genuine intimacy and connection based on mutual trust, acceptance, and vulnerability. Further, tolerating bad feelings better equipped one to empathize with others' struggles and perspectives, fostering compassion and solidarity within their communities.
The inability to tolerate distress increases symptoms of depression
Trauma and Distress Tolerance
Knee Surgery Can Suck
Recovery can be painful…
It is not uncommon for clients to experience feelings of anger, sadness, grief, and frustration during therapy…and even toward their therapist at some points. Therapy can bring up challenging emotions and insights, and the therapeutic relationship can sometimes be a source of tension or conflict. Actually, this is good* because therapy becomes a workshop for your life outside the therapy office, which is really the whole goal.
*Part of therapy is discerning when to set boundaries or speak up, when to self-reflect. Feeling uncomfortable does not mean tolerating abuse, -isms, judgment, blame. Therapy may help you respond in more effective ways.
Working through trauma, childhood attachment wounds, unhelpful thinking patterns, reflecting on unconscious patterns, and practicing nervous system regulation is no walk in the park. No matter the therapy modality, there is discomfort. But the good news is the discomfort here has a point (as opposed to how it often is in the real world): the point of discomfort is to greatly improve your life!
The psychological benefit of accepting negative emotions
Embracing negative emotions increases well-being
An Important Note On Physical Therapy
Please do not run a marathon right after surgery!
In trauma theory, titration refers to the careful and gradual exploration and processing of traumatic experiences in therapy or self-reflection. Think again of an injured knee…you don’t start by running, start by stretching. By titrating the exploration of trauma, individuals can gradually build tolerance for distressing emotions and sensations, while also developing coping skills and resources to manage overwhelming reactions. This approach facilitates the healing process by providing a safe and supportive environment for individuals to gradually confront and make sense of their traumatic experiences, leading to increased resilience and psychological well-being.
Learning to Ice Your Own Knee
Reliance on a therapist (or any one person) for comfort can lead to emotional dependency, where individuals become overly reliant on their therapist for validation, reassurance, and coping with stress. This dependency can hinder personal growth and autonomy within the relationship. Ideally, a therapist helps model and teach a client to emotionally soothe themselves and build a community of relationships that help provide co-regulation, validation, and comfort. We all seek comfort and need community support, this is not about individualism. Sometimes we ask a friend to fetch the ice! However, constantly seeking comfort or overreacting to uncomfortable moments or disapointment may impact one's self-esteem and self-perception within the relationship. It may lead to feelings of inadequacy or unworthiness if another’s responses fail to meet your specific expectations. It’s important to both have community care and the ability to care for one’s emotions.
Learning to regulate emotions and tolerate discomfort is important–and difficult. Those who effectively manage their emotions are less likely to experience symptoms of anxiety, depression, and other psychological disorders. Therapists play a crucial role in teaching clients skills for emotion regulation and distress tolerance, which can lead to better mental health outcomes. If tolerating discomfort is difficult for you and therapy is not helping you learn to self-sooth, grow resilience, build community, and use discernment, therapy is creating a dependency environment that is potentially exploitative at worst and ineffective therapy at best.
