Hammersmith author Michael Guilding wrote a brilliant new piece for Psychology Today. Michael is the author of Fear in the Therapy Room.
In “The Fear System at Work,” Michael draws on years of clinical experience. He explores something therapists rarely discuss openly: the fear response doesn’t just belong to the patient. Therapists feel it too. Learning to recognise and work with that shared fear — rather than around it — can deepen the therapeutic bond.
Below is a short extract. Read the full piece on the Psychology Today website.
It was just the start of our second session, but we were in deep trouble already. Christopher was agitated, talking really quickly and with a sense of urgency. There was something he said I needed to know, but I couldn’t follow him; nothing made sense. The harder I tried, the more confused I got; I felt I was losing the plot. I thought: Is this a psychotic episode? That made me panic; my heart was beating fast, and I felt hot all over. What should I do? My mind went blank.
I thought, Here we go again, my fear system has just kicked off. I knew what to do now. Stop working, observe my breathing, nothing else. A couple of moments later, a bit calmer, I focused my attention on my body, my agitation and sense of disconnection, and my fear of craziness. A thought came into my head: “He’s scared he’s going mad.” At the same time, I had a mental picture of an astronaut, with his connection to his spacecraft severed, floating off into black, endless space.
We had a moment of real connection, then we were able to start working together to make sense of all of this, both of us having recovered the ability to think reflectively.
Right at the core of psychotherapy is the human fear system – a set of biological processes which form our instant, automatic and unconscious reactions to threat. We have three key fear responses depending on how close the danger is.
When the danger is some way off, and we are not sure what the threat is, we go into fear alert—our senses become more acute as we scan the environment, and our nervous system readies our body to explode into action if needed. We tense and hold our breath – we feel anxious, wary and on edge.
When danger is close, we are in fear arousal; the body changes and boosts our energy so we can hit harder and run faster to escape the threat. Where it is not obvious how to escape, our body might lock in a freeze or our heart rate might peak in terror, a state of ‘fright’ that can tip us into the final fear response. With fear arousal, we might experience a huge upwards-moving rush of energy such as when we really lose our temper—our heart beats faster—we run or shout or lash out, or we might go rigid in terror or panic and our mind blanks. In this state we can’t focus on anything but danger, and we lose our ability to think reflectively.
