“Without emotions, it is impossible to transform darkness into light and apathy into movement. »

Carl Gustav Jung

emotion palo alto


Our discussions today focused on my observation of the management of emotions in strategic therapy and the posture of the therapist in this emotional work.

Indeed, emotions are at the heart of our existence and we frequently meet patients who express their emotions more or less easily and clearly. And then there are those who consult because the emotion has turned into an emotional disorder, covering pathological symptoms that can last from a few weeks to sometimes a few years. Faced with these sensitive situations, sometimes destabilizing as a therapist, we can feel helpless and such situations often lead to relationship ruptures or even therapeutic blockages. And these can have important consequences for both the patient and the therapist. Also, even if emotion can be part of the problem, it can be a therapeutic lever.

The heart of the strategic approach is to explore, first, the functioning of the problem by identifying the "attempted solution" then, secondly, to neutralize it in order to allow the patient to live corrective emotional experiences that gradually, will become a new bodily anchor point for the patient. This encourages him to amplify and renew the experience. New strong referents, they allow him to avoid going back and not falling back into a dysfunctional schema or pathology.

All my work of observation and exploration made me realize that the strategic approach approaches emotion not only as an inner state, but an association of several powerful elements and that it integrates it completely into the therapeutic process. It is a crossing point between cognitive work and behavioral work. We act according to what we think and emotions are also linked to this.

The regulation process, for the therapist, is to work in this circularity by modifying in particular the cognitive, emotional and behavioral elements, which constitute the “dysfunctional solution” of the patient. All this allows me to pose this nuance in the process of emotional regulation: it is a work of regulation by the emotion and not of the emotion. In this sense, emotion is a mediator of change.

fear phobia

We discussed the case study of Alexandre, 24 years old, who consults for a phobic disorder that he has had for 6 years. During a stay on vacation with friends, after an alcoholic evening, he had a tachycardia attack while driving, which led him to the hospital. He thought he was going to die.  

He feels limited and frustrated that he cannot travel as he sees fit without experiencing anxiety or anguish. This very restricted framework also impacts his social life. He feels closed off and ashamed of what he is going through. Also, this geographical openness would also allow him a relational openness - because more fulfilled and happier if he managed to overcome his fears.

It is a difficulty that he experiences with himself and that he tries to overcome alone. He has already tried different accompaniments such as hypnosis, EMDR and psychotherapy to help him overcome his difficulty. It helped him get a little better but didn't help solve his problem for good. A feeling of helplessness and disappointment sets in.

Overwhelmed by his fear, he therefore avoids situations that frighten him and tries to control his feelings of fear and anxiety. The strategic movement put in place by the therapist was to co-construct with the patient cognitive and behavioral alternatives to reverse the dysfunctional dynamic. Indeed, reframing the fear with the patient that "a fear that we avoid turns into panic and that a fear that we face turns into courage", and in parallel prescribe the symptom with the task of the "fantasy of worse” allowed over the course of the sessions to free Alexandre from his phobic fear, to confront the situations he had avoided until then and even to transmute his fear into pleasure.


Finally, we discussed at length the fact that the work of emotional regulation requires know-how and know-how from the therapist. Indeed, the know-how of a therapist is not solely centered on the dysfunctions or the pathologies to be treated. One of his fundamental skills in particular also lies in his ability to take into account and exploit emotional feelings – his own as well as that of the patient.

The taking into account of the emotional aspect of the attempts at solution is thus placed at the service of the strategy deployed by the intervener. And even if working with them does not guarantee a total solution to the patient's problem, this dynamic nevertheless makes it possible to open up therapeutic perspectives and to participate clearly in the improvement of the therapeutic alliance, in other words the relationship, being the heart of the psychotherapy.

Claire Tanne