We understand this, even if we have to stop and make ourselves think about it: everything we know begins with our perception of it. The color of a car parked in the shade; the firmness of a peach at the market; the smell of dinner cooking; the mood of the man walking across the street – all these things we know as a function of our perception of them. We trust our perceptual systems so much that they are a relatively invisible part of the process. Equally true, if less obvious, is that even a physician’s or psychologist’s ostensibly objective knowledge of our internal physiological states – including neuropsychological events – is filtered by their perception of them.
Whether we can know anything outside the world as we experience it is an interesting philosophical question, but it has profound implications when we try to understand another person. This is particularly true in the context of psychotherapy and trying to help another person heal.
Much of modern day psychiatry, psychology, and psychological research operates under the illusion that physiology is primary. In fact, our experience is always primary, and this includes our experience of our physiology.
Though depression may have some relationship to fluctuating serotonin levels in your brain, depression is not your fluctuating serotonin levels. Depression is part of your experience. It is a mood that overcomes you or a shift in the way you experience the world. You may feel you cannot keep up with the world’s demands. Nothing matters. Both the world and your future feel grey.
Or consider anxiety: You can’t concentrate. You’re worried. You feel like you can’t stand still. You may feel dizzy, faint, sweaty, you feel the world has become far away. It can appear as though you are looking through the wrong end of a telescope. Though anxiety may have some relationship to changes in anxiety-specific neurotransmitters, anxiety is not changed neurotransmitters. It is an experience.
In both examples – depression and anxiety – your experience of these circumstances or events is at issue.
Psychotherapists must always start off trying to meet their patients on an experiential level. Failing to do so leads to objectification and dehumanization of the other person. Whether or not various psychological techniques are used, or physiological interventions such as medication are administered, a therapist’s primary task begins in finding access to the patient’s emotional state. The work of a therapist must involve the experience of the patient in all its nuance and complexity.
For the therapist who works within an experiential framework, a large part of the work must involve finding access to the experiences of his patients in himself. While being a warm and caring therapist may be important, it is relatively hollow in contrast to the therapist actually having a sense of how it feels to be you, how it feels to be experiencing the world as you do. A therapist must be comfortable sitting with feelings, both yours and his own, if he is to be helpful. The need to objectify patients and rely primarily on a conceptual or theoretical understanding of their problems, or a categorical diagnosis, often serves as a defense and blocks truly knowing the patient’s suffering and struggles.