Being With Feelings as a Recognition Practice: Developing Clients Self‐Understanding

TOPIC. How are shifts in clients' self-understanding related to focusing on feelings during therapy sessions? METHODS. A phenomenological study involving matched-pairs of clients and nurse-therapists using video-cued narrative reflection. FINDINGS. Feelings disclose significance within a therapy session. Dialogical relationships and involvements help clients experience the feelings they are discussing, obtain feedback from therapists, and develop self-understanding. CONCLUSIONS. Nurse educators should stress the importance of focusing on feelings in a session, and clinicians should practice this skill to facilitate a client's developing self-understanding. Key words: Affective awareness, nurse-client relationships, self-understanding Self-identity and self-understanding have long been focal points of therapeutic discourse and key topics within the psychotherapeutic literature. It also has been known for some time that focusing on feelings within a therapy session is effective. Freud (1939/1964) suggested that clients defend against painful memories and displace the affect associated with memories of traumatic events onto other indirectly associated situations and relationships. Consequently, those indirectly associated situations and relationships become invested with a great deal of affect. A primary task of therapy is to focus on feelings and to explore memories similar to those being discussed that generate the affective response. Additionally, Freud suggested that a therapist who is familiar with the feelings he or she has experienced during analysis is more likely to recognize and understand a client's affective-laden response. Being attentive to feelings during a session enhances the client-therapist bond and facilitates the client's psychological progress and growth. The question of identity and self-understanding and the significance of focusing on feelings also is of concern in Heideggerian phenomenology, which was both the method and philosophical underpinning of this study. People, according to Heidegger (1962), are self-interpreting beings involved in a world of direct experience. People are defined by living their life. It is in the doing and living of life that people come to understand themselves. People are constituted by relationships, shaped by involvements, influenced by dialogue and language, and defined by their concerns (Heidegger). Heidegger spoke of emotions as signs that "indicate where one's concern dwells and what sort of involvement there is with something" (p. 111). He commented that affectivity is a way of disclosing a situation "out of which we encounter what matters to us" (p. 177). Affectivity and understanding always go together for Heidegger: "Affectivity always has its understanding and understanding is always attuned" (p. 183) to significant life events and relationships. Charles Taylor (1991) also addressed the relationship between self-understanding, identity, and affective awareness. He commented, "My identity is defined by the commitments and identifications which provide the frame or horizon within which I can determine ... what is good or what I endorse or oppose" (p. 27). Taylor reflected on the dialogical character of being and language, including the language of gesture as well as words. He suggested we define ourselves and our identity in dialogical relationship with others. Taylor explicated Bakhtine's idea that human beings are constituted in conversation, in rhythmic dialogues of involvement. He commented that "identity needs and is vulnerable to recognition given or withheld by others" (p. 49). Taylor also suggested that "Feeling is an affective awareness of a situation" (p. 167), and that understanding is anchored in feeling. Articulating an issue or concern is an ongoing process, according to Taylor. We express, penetrate more deeply, and continue to describe. Feelings, emotions, and understandings are changed by this description and dialogue. …