Is anger the only feeling you focus on?

“I have a novice ISTDP question if that’s ok.

When asking a patient about his/her feeling toward someone, is anger the only option? Of the handful of major emotions, anger seems to be the only one you can feel toward a person.”

Thanks for asking this question. If someone’s child has died of an incurable illness, you will assume he is feeling grief. So you could ask, “I wonder what feelings are coming up now that your son has died?” Then watch for defenses against grief.

If someone has had a fantastic success but seems muted, you can ask, “I wonder what feelings you have now that you have won this award?” Then look for defenses against the joy of being a victor over others.

If someone has done a shameful thing to someone, you can ask, “I wonder what feelings you have now as you realize you destroyed her chances to get a new job?” Then look for defenses against shame or guilt.

If someone has been wronged, you can ask, “What is the feeling toward him for doing that?”

We can have many feelings, each of which can be warded off. We shape the question according to the feeling we would assume the patient is struggling with. We focus a lot on anger because it tends to be the most conflictual for patients and is the one in the forefront. However, ISTDP is not only about anger. It is about helping patients face their complex mixed feelings: rage, love, guilt, and grief. Due to their difficulty tolerating complex emotions toward loved ones, patients use defenses which punish patients and cause symptoms that bring them to treatment. If we can help them bear their underlying feelings, defenses are no longer necessary, their neurotic suffering can end, they can have an integrated sense of themselves and an integrated wholistic sense of their loved ones.

 

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