One Sign of “Hitting the Mark” in Psychotherapy

Does your body give you a sign that you’re on target?

A beautiful sunriseStrongly committed to the goal of helping my patient to manage the experience of living in the world as it IS and in the self that he/she IS– in practicing the art of psychotherapy — I am grateful to have an unusual sign that reinforces my cognitive intuition that our work is on a fruitful path.

As a psychoanalytically oriented psychotherapist, the instrument I have is my Self. A patient can trust me insofar as I know myself, am committed to taking responsibility for myself, and am clear that my intention as therapist is to be of service to my patient. These are conscious matters — matters of which I am consciously aware. These are matters that require steady, conscious work.

The work of psychotherapy is conscious work that significantly relies on clues from the unconscious. We pay attention to our patient’s and to our own mental associations. We consider and analyze the content of a patient’s dreams. These messages from the unconscious come to us cognitively. As with all thoughts, we may be “pretty sure” of what we understand — but there’s always a possibility of doubt.

However, the body can send a message both unbidden and unmistakable.

Goosebumps. No doubt about it. Goosebumps.

When, during a psychotherapy session, I develop goosebumps (experienced usually on my arms and legs) pretty regularly I say (to myself, but sometimes, if the moment is right, aloud) , “I know that we are onto something important here. I’m having goosebumps.”

“Goosebumps can indicate that your intuition knows you have hit the mark perfectly” says Dr. Judith Orloff, author of many books on the subject of intuitive healing.

Having goosebumps is, for me, a signal that my patient and I are in a therapeutic zone — that the working connection is good enough, and that we are at that moment paying attention to particular facts and feelings in the patient’s life that need attention.

Doubtlessly not ALL committed, responsible, and effective therapists experience goosebumps during the course of their work. Those of us who DO are fortunate to have this signal of encouragement to investigate further the material we are exploring with our patient at the time.

~ Susan Rako, M.D.






TL;DR Newton, MA psychotherapist Susan Rako, MD discusses the body’s response to clues from subconscious work.