Okay, so I admit to being a bit disingenuous: I should come clean and clarify that this is not a blog post on how to improve your sex life. But the question of optimal arousal (or a slightly differently-worded version thereof) is often with me during my 50-minute hours with clients.
The Window of Tolerance
The window of tolerance is described by Daniel Siegel in his book The Developing Mind (1999) and refers to the optimal physical and emotional state for internal well-being and external functioning. In psychotherapy, this translates into the client being able to process difficult emotional material without becoming hyperaroused:
Neither state is what we want to see in our therapy offices: neither is optimal for lasting change to take place.
What I’m looking for in sessions with my clients is a fluctuating state of arousal within a (client-specific) window of tolerance—not too hot on the Bunsen burner flame under the couch, and not too soothing, lulling, or comfortable (I especially have to watch out for the latter: my beloved down-filled blue couch is particularly welcoming and soporific). Here’s a graph of what I’m talking about:
As Pat Ogden states beautifully: “When arousal falls within this window [of tolerance], information received from both internal and external environments can be integrated” (Ogden 2009). I can tell when my client is in this window, because of the sparkling energy in the room, the attuned connection I feel, the moments of fabulous client insight, and the beautiful emotion that flows freely from but without flooding or overwhelming the client.
If things go awry, this is what can happen:
Being easily triggered to a state of hyperarousal can be a sign of past trauma, and remaining in this state can lead to retraumatization of the client (which of course we want to avoid: do no harm!). A client freezing, numbing, or dissociating (falling below the optimal arousal zone/window of tolerance) can also be a result of past trauma. Both states arise from the fight/flight/freeze/fold options for self-defense that are part of our early mammalian legacy. In either case, lasting therapeutic change can’t take place: there’s either too much or too little arousal to process and integrate the material being explored. Not to mention that the client drifting off into dreamland is not hearing a word I am saying (and in my worst nightmare is loudly snoring).
How to Remain in the Window of Tolerance (or How to Stay Optimally Aroused)
One of the things that keeps me riveted to my chair week after week is the creative effort psychotherapy requires in my being highly attuned to my client, doing my best to help her work at the edges of her unique window of tolerance, “safe but not too safe” (Siegel, as cited in Bevans 2013). I have to admit that growing into my role as a therapist has required that I work hard at overcoming bits of my socialization as the child of highly principled Southern parents, you know: “if you can’t say something nice, don’t say anything at all,” etc. But with practice, I’ve come more into my own in realizing the necessity of inviting, coaxing, cajoling, pushing, or doing whatever it takes to get clients out of the middle of their comfort zone and out to the less familiar edges of the window of tolerance, where great exploration and discovery can take place. A lot of this work is accomplished by watching the client closely, noticing my own reactions, naming what’s happening in the room, making the inevitable mistakes, trying again, repairing ruptures that occur, and ultimately trusting the mysterious process that is therapy. Here is what I would like to see taking place on my couch (figuratively, of course, except for maybe with some of my more adventuresome kid clients):
And that’s my View of the Couch!
Bevans, Kimberly. 2013. The window of tolerance: edges of growth. http://www.bostoneveningtherapy.com/2013/06/the-window-of-tolerance-edges-of-growth/
Ogden, Pat and Kekuni Minton. 2000. Sensorimotor psychotherapy: one method for processing traumatic memory. Traumatology Volume VI, Issue 3, Article 3.
Odgen, Pat. 2009. In: Clinical Pearls of Wisdom: 21 Leading Therapists Offer Their Key Insights. Michael Kerman, editor. W. W. Norton & Company, Inc.
Siegal, Daniel J. 1999. The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press: New York, London.
Cristian Bortes, photographer, via Magdeleine.co