There is an important distinction between feeling safe and being safe
“Everyone has a right to feel safe.” “I want you to feel really safe in my office.” These are things I often hear from other therapists and I find myself cringing in response. While there are worthwhile underlying values of safety inherent in these statements, there is also an unhelpful conflation between being safe and feeling safe—a conflation that is pervasive both in our culture in general and in therapy.
As I mentioned in a segment, “Therapy’s Fingerprints Are Everywhere,” on WNYC’s All Of It with Alison Stewart, I am responsible as a therapist for maintaining that patients be safe in my office. However, I also believe therapists need to invite feelings that may not feel so safe in the practice of therapy—making room to talk through emotional experiences that may not feel so good or may be scary. What we lose when we assert, “Everyone must feel safe and if you feel unsafe, something is wrong,” is the potential to understand the difference between being and feeling unsafe, as well as the opportunity to negotiate safety together.
It’s easy to confuse avoidance of painful things with good therapy
Privileging felt safety above healing, including the necessary disruptions and breakdowns that are so often a predicate to healing, is a problem for therapy. There is something appealing about being offered, in the form of therapeutic treatments, a world in which feeling unsafe (but perhaps being safe) is synonymous with unsafety. It’s a fantasy of childhood. No healthy caregiver questions the tears of a newborn, even when the bottle is being warmed and just mere seconds away. In infancy, we’re granted the right to be upset or scared absent any filter of rationality. But one of the demands of adulthood is that we are not merely servants to our feelings, no matter how painful they may be.
Certain therapies explicitly teach people to override their sense that something is unsafe. Take, for instance, exposure therapies that acclimate these feelings through repeated exposure or cognitive therapies that reframe thoughts or codify skills of distraction. These approaches can be immediately helpful for people to break through barriers of feeling unsafe (and the accompanying worry). However, they also skip several key pieces: examining whether a situation is, in fact, unsafe, developing an individual’s capacity to use their sense of fear and the thoughts that accompany it to keep themselves safe, and exploring the origin of a false or exaggerated sense of unsafety (as much as it’s false or exaggerated). In other words, these approaches avoid asking the key question: Where did this come from?
Feeling unsafe in safe situations is an issue that brings people into individual therapy
Safety is a basic human need that has been formative to our evolution. Experiences of being unsafe constitute all of what we might consider trauma and influence nearly every aspect of our emotional development writ large. Safety is also a location of coercion and confusion. As a result, often because of complicated issues from their emotional pasts, many feel unsafe in situations where they are safe, safe in situations where they are unsafe, and, most commonly, a confusing tangle of both.
Whether they realize it or not, many people come into individual therapy because they feel unsafe in safe situations. For these individuals, a blanket assurance of safety is as much of a disservice as ignoring the issue altogether. People are understandably wary of therapists. There is power in the position and vulnerability in the activity. Safety isn’t static and we, as therapists, do not become safe by virtue of our credentials, experience, or some other proxy alone.
Instead, developing safety, examining feelings and values, and identifying markers through which safety becomes more and more assured aren’t just the preconditions of safety; they’re essential parts of the therapy itself. We need to explore all of this as a part of helping patients navigate the dialectic of risk/safety in the world, including understanding and working through past experiences in which their safety was attacked.
Therapy isn’t without risk (as all intimacy is risky)
When considering the difference between feeling and being unsafe, it’s also important to discuss risk. Some activities in life mean embracing both felt and lived unsafety. Rock climbing, for instance, is risky with a measurable unsafety and yet many nonetheless find it worth it. Developing and learning can also feel and, in some ways, be unsafe. Growth can be a disruption. It can feel scary to ride a bike and while it’s not without risk, it’s also generally not as unsafe as it feels when it’s new. Likewise, it can feel scary to talk about sexuality in a grad school class, but when thoughtfully led, it simply isn’t unsafe.
Similarly, therapy can also be quite risky as all intimacy is risky. The very pathways through which we invite others to know us are the same pathways through which we invite people to harm us. There is no way around this dual reality: inviting love is inviting a risk of harm.
For example, I’ll occasionally stumble on a comment on social media that says something to the effect of, “These are questions a therapist should never ask.” It’s clear that there are endless questions that might be asked in therapy at the wrong time or when not enough trust has been built to receive them well. This is a risk of doing therapy (and, of course, even the “mistake” of asking too soon or misreading consent can have therapeutic value). But this, too, is a relationship that must be negotiated: How might a patient and their therapist invite inquiry regarding things that are uncomfortable, stigmatized, provocative, or disruptive? How do we work to create the conditions to look at everything that needs to be looked at, even things that feel unsafe?