Episode Overview

Podcast: The Leading Edge in Emotionally Focused Therapy
Hosts: Dr. James Hawkins and Dr. Ryan Rana
Episode: 99. What Scares Therapists: Caution with Blocks: Being Overly Controlling & Shutting Clients Down or Missing Them
Date: October 21, 2024

This episode explores therapists’ fears about becoming overly controlling when working with client “blocks” (or, as reframed, “anchors”) in Emotionally Focused Therapy (EFT). The hosts, Dr. Hawkins and Dr. Rana, dive into the balance required to address blocks—how to maintain focus and therapeutic progress without shutting clients down or missing underlying vulnerability. The discussion is both practical and philosophical, providing stories, examples, and conceptual reframes to help therapists reflect on their own styles and grow past their fears.

Key Discussion Points & Insights

The Dilemma: Activity vs. Attunement

• What Scares Therapists?
  • The episode is prompted by a conversation with colleague Olivia “OJ” Jones, who voices concern about overly shutting down clients when trying to manage blocks (03:00).
  • This reveals a therapist’s fear of inadvertently harming the alliance or missing key client experiences by being too controlling.

Reframing “Blocks” as “Anchors”

• The hosts refer to George Faller’s teaching—describing blocks not as pathology, but as “anchors” representing a client's hesitation or mistrust to move toward vulnerability (05:09).
  • Dr. Hawkins:

    “The client might say, ‘I’m not sure if I want to proceed,’ and they drop an anchor … the anchor is their mistrust saying, ‘I’m not sure if I’m comfortable going further.’” (06:07)

  • The therapist’s job is to recognize when an anchor has been dropped, get curious about its function, and help the client safely “pull up the anchor.”

Therapy is Real, Serious Work

• Dr. Rana shares a personal story of loss involving a real anchor, emphasizing the seriousness and risks involved in these moments, both for clients and relationships (07:35).
  • Dr. Rana:

    “These are real people. We’re trying to do our part to make a space to potentially save, salvage a relationship. And so really, how we manage these anchor moments … goes a long way.” (08:13)

The Core Challenge: How Much Control?

• Focus is Key, But…

  • Effective EFT requires taking control at key moments—actively redirecting, summarizing, or interrupting the process when it helps (10:14).
  • But there’s always a risk. Too much control can:
    • Shut down client emotion/vulnerability.
    • Harm the therapeutic alliance.
    • Make therapy feel done to the client, not with them.

• The Flexible Middle:

  • Therapy “block style” needs to be proportional:
    • Small blocks might warrant a light touch or no intervention.
    • Medium blocks might need more engagement.
    • Big blocks can require significant, focused interventions—“CPR and parts work” (13:00).
  • Dr. Hawkins:

    “We’re not doing CPR and terror work with every single block every session.” (13:02)

Therapist Anxiety vs. Attunement

• Therapists must discern whether a controlling urge comes from their own anxiety or from genuine attunement to the client’s needs (14:25).
  • Dr. Rana:

    “Is that my anxiety? Or is that really an attuned moment to what’s happening in front of me? Important questions.” (14:25)

Case Examples: When to Intervene

• Family Session Example (16:45):

  • Dr. Hawkins shares a case where catching a subtle dismissive moment in a client (“It’s not really that big...it’s not that important though”) led to a transformative session. Timing and focus opened vulnerability and connection for the family.
    • Dr. Hawkins:

      “James, do not let this moment go.” (16:40)

    • The risk paid off—choosing to focus at the right moment enabled real healing.

• Admitting Mistakes:

  • Sometimes trying to “catch” every block backfires, and therapists must make amends for pushing too hard.

Therapist Style and Working with Blocks

• Different Therapists, Different Alliance Strengths:

  • Some excel at warmth and presence (Becca Jorgensen, Leanne Campbell); others achieve alliance through visible determination or intensity (Ryan Rana).
  • All styles have a “shadow side”—gentle therapists must assert themselves, forceful therapists must soften strategically (19:17).

• Session Structure/Habits:

  • Dr. Rana describes using focused cycle summaries to begin sessions and then intentionally making space for clients to share before stepping in with strong interventions—balancing structure and openness for optimal progress (19:29–24:00).

The Importance of Flexibility

• Secure vs. Insecure Attachment:

  • Flexible, adaptive responding is a marker of a secure therapist. When therapists are rigid (over-focused or under-focused), it reflects their own insecurity.
  • Dr. Hawkins quoting Dr. Rana:

    “What’s the first thing you lose when you’re in an insecure attachment? … The ability to be flexible.” (25:01)

• Therapist Growth:

  • Therapists must model flexibility themselves, toggling between business (focus/intervention) and humanity (space, patience), just as they hope clients will grow (26:21).

Notable Quotes & Moments

• Reframing blocks:

  • “We really use [blocks] to talk about...when we’re on the path to working with someone’s vulnerability and their body just sends off a little bit of cue of a mistrust...”
    — Dr. Hawkins (05:09)

• The risk of missing important moments:

  • “If you just make a quick validation, or a quick pass, or even just try to have empathy towards [a big block], it’s just going to keep sitting there forever...it’s going to continue to do harm.”
    — Dr. Rana (13:06)

• Introspection on making mistakes:

  • “I catch myself doing this sometimes and it’s like I didn’t need that much control. Is that my anxiety? Or is that really an attuned moment to what’s happening in front of me?”
    — Dr. Rana (14:25)

• How personal styles inform therapy:

  • “You’re not the easiest person to open up to initially, but what really made me trust you is how hard you worked. There was an intensity in working with you...”
    — Dr. Rana, quoting feedback from past clients (19:30)

• Alliance and flexibility:

  • “While we’re trying to help teach and model kind of secure attachment, we also gotta model it ourselves. And that means we, as therapists, have to be able to be flexible.”
    — Dr. Hawkins (25:01)

• Practicing vulnerability with peers:

  • “The worst thing that can happen to you as a therapist is that you begin to hold your own fears out of fear of imposter syndrome or that other people don’t go through it. Our bodies need permission to kind of get these fears out so we can be our most open, kind of available self.”
    — Dr. Hawkins (29:03)

Timestamps for Important Segments

• 03:00 — Olivia "OJ" Jones reframes fear of shutting clients down
• 05:09 — George Faller’s “anchor” metaphor for blocks
• 07:35 — Real-world story about the consequences and seriousness of “anchor moments”
• 10:14 — The risks of not taking control versus being too controlling
• 13:00 — Tangible framework: varying interventions based on the size of the block
• 14:25 — Therapist’s anxiety versus genuine need to intervene
• 16:45 — Dr. Hawkins’ pivotal family therapy example
• 19:29 — Alliance styles and session structure—balancing focus and space
• 25:01 — Flexibility as a marker of secure therapist functioning
• 29:03 — The importance of peer support and sharing therapist fears

Conclusion & Takeaways

• Effective EFT requires “walking the line” between necessary control and attuned flexibility.
• Handling blocks well is a signature of competence, but therapists must always weigh the risk of being too forceful versus too passive.
• Noticing therapist anxiety, reflecting on one’s own tendencies, and being willing to make repairs are all essential.
• Therapists are encouraged to process and share their fears with peers, not hide them.
• Modeling secure, flexible responses is as important for therapists as it is as an intervention with clients.

“There’s good reasons to be scared, and yet you’re not alone in the fear. We got places we can talk about this. We got places we can make space for this. And we’re with you.”
— Dr. Rana (28:42)