Learner therapist (4) a breath of life?

Learner therapist (4) a breath of life?
Torrey Orton
April 7, 2011


In my search for patients' agency, and the author within who drives them (if other things don't get there first), I'm increasingly noticing little signals of activity. This is a matter of small sounds and slight expressions. These may grow into loud sounds and gross expressions as modelled for us all with indelible memorability by Homer Simpson.* Among the hardest things to say for the injured are words of self-approval or words disapproval of family sources of their injuries. I suspect such words are what are coming into hearing/view through the little breaths below.


I offer these signals as enticement to others to share their bits in the hope that we can develop a taxonomy of little expressions to join the forces of little steps. The point here, as there, is to enhance patients' awareness of ways in which and times at which they are taking small steps towards their emerging selves. It is our responsibility to provide such help, since they are often blind to their own agency and ignorant of the myriad forms it can take.


Small breaths…

For instance, "phuuh" is a sound I cannot spell. Yet it reaches me these days like a declaration of dry despair, usually arising out of the flatlands of a psycho-spiritual plateau, often mid-session midway through a therapy engagement. It is a quiet, almost inaudible expression barely strong enough to be heard, more seen than heard in the slightly pursed lips of a patient. Or myself, too, I'm noticing these days. The sound occurs often in synch with a slight movement of the head away from the line of eye to eye engagement, the kind of movement which also signals an emerging insight or feeling.

Apathetic Irritated

Further along this spectrum lies a dry spitting sound - "pffft" - which ejects a thought or feeling mildly but certainly. It often has a comment hidden in it. The speaker seems not to quite embrace it, but the thought is out enough that it cannot be restrained. The "pffft" is more about getting the fact that they have a thought out than making that thought visible.

Disturbed

Another grade along is the wet, spat ejection….a slight swear.

Annoyed

"Doh" or "doah" – derisive mimicry of dopey other(s), which, depending on the tone of speaking, may be cuttingly abrasive (an aggression) or just a twitch of the rhetorical tail (a slight gotcha).

Angered

"pfauuugh" is towards the other end of the exhalatory spectrum, a clear rush of derisive disapproval, amazement that another does not share one's own insight, sensitivity, …..or one missed it oneself!!

Enraged

These can all be applied recursively – directed at oneself as well as others. I'm not sure of my classification of expressions by feeling levels, but there's something systemic about them in the anger spectrum. Kassinove and Tafrate's "Anger Thermometer" has 10 grades of anger marked by ten vocabulary steps. These are more distinctions than I know how to use, but some psychs feel comfortable enough to publish them so facility with the distinctions may be useful.



*By the way, 50 years ago when in boarding school, an expression indistinguishable from Homer's "doh" was a popular reproach to another teenage dope's intellectual or behavioural vacuity of the moment. No one escaped the title! How did it transit all those decades?? Is this just another item in the records of the eternal return?? If the latter, then 'doh' arises from a deep cultural meme or, as the neuropsychs might have it, hard-wiring.