The ultimate holistic goal of providing emotional support and therapeutic presence is the intentional facilitation of supporting a person to stay self-compassionate within their own experience of emotional pain. This requires those we care for to become comfortable with recognising and experiencing their whole selves. When people seek care, they rarely start by saying that they want a more intimate relationship with themselves. More often it is a result of a loss or a life change, where their life experience becomes something other than they'd planned, and they want ways of stopping the pain or cycle.
What is ironic is that as we journey with our clients to tolerate more of their experience, they often discover that they can withstand, integrate, and calibrate more than they ever imagined. This process of 'staying with' one's own experience cultivates awareness, coherence of feelings, strength, and the resilience to stay present to self as they mourn and grieve the loss, change and trauma.
As clients begin to inquire more intentionally about their experience, considering their current circumstances, it becomes clear that often the emotional pain they carry has come from relationships with significant others who have not seen, nor responded to their needs, and therefore it is hard to trust any support in their time of greatest need.
Relational betrayal and sabotage occur along a continuum from intrusive to neglectful behaviours. Extensive betrayals and unmet needs leave the individual with a deep sense that they were not important to those around them. Relationships can become unsafe, including their relationship with authority figures or their God, and the physical and psychological discomfort of this core belief can be overwhelming to experience. As a result, individuals often adapt by developing behaviors, symptoms, and reactions to deal with the impact. These can include depressed states, anxiety, inability to rest, somatisation, perfectionism, lack of boundaries, self-reliance, anger, and despair to name a few. These adaptations restrict self-awareness and can leave people afraid of their own experience, disconnecting them from their relationship to self, others, nature and the divine. The foundation of the therapeutic relationship is that the focus of attention is on the client’s present moment experience and as we stay mindfully present to their experience without leaving [as in the previous betrayals], we can begin to restore the safety of the relationship and renew the sense of trust, boundaries, and ability to stay within a safe relationship.
As caregivers, our developed self-awareness is the most important attribute in attunement as a therapeutic skill. Helping us to remain in a postural state of 'ease', fully present and able to apply mindful reactions to comprehend the client’s re-enactment of their world. An intentional commitment to personal reflexive work and the development of our ability to attune is therefore crucial in witnessing and supporting the client's needs, subconscious presentations, and present moment experience as the move towards integration of lived experience and inner healing.
When caregivers work from a posture of 'ease', the matrix of intra and inter-relationship supports and guides the direction and flow within any person-centered encounter. Without attunement to self and others, we develop a power-centered encounter that limits curiosity, makes assumptions about the client's needs, turns empathy into sympathy, disregards the value of their lived experience and dysregulates our nervous system producing high problem-solving, efforting and fatigue.
Definition of Attunement
A definition of attunement ‘is a kinesthetic and emotional sensing of others knowing their rhythm, affect and experience by metaphorically being in their skin, and going beyond empathy to create a two-person experience of unbroken feeling connectedness by providing a reciprocal affect and/or resonating response’. (Erksine 1998). One could say it is our ability to be present to, and with, another’s expression of their experience. Attunement could be thought of as the meta-skill which might have subheadings, such as empathy, mindfulness, immediacy, active listening, presence, experience and knowledge, and cognitive understanding. Any of these skills on their own is not attunement, but at times comes into ‘tuning into’ our clients as we explore with curiosity and connect to them.
The ability to be attuned really comes down to how connected to our clients we are in the moment-to-moment process of providing care, _and_ how reflexive we've become in our own personhood, qualifying us with the ability to connect authentically and fully present to them. Our presence, response and interventions are then a result of this attunement
“To be present means to be consciously attuned to the person before you. Naomi Remen describes this kind of attuned presence as being ‘seen by the heart’. It happens when you see the other, listen to and hear the other, and give your undivided attention to the one in your care…. Attunement is a feeling of harmony or oneness with another being, it is both a way of being and a way of doing. It’s the experience of focusing on another person with openness and acceptance.” See Me as a Person Guidebook pg. 50.
Journaling Prompts for Attunement
When you were on the receiving end of a relational mis-attunement, how did it feel? Can you remember your body's experience at that time?
When you have missed or messed up attuning to another, how did it feel? Knowing what you know now, what would you do differently?
How do you consciously attune to the client/patient? Think of the ways - posture, actions, and attitudes you actively employ to engage in the therapeutic relationship.
What is your primary goal when attuning to the patient present moment experience?
As a patient hold “hopes” for healing, recovery or even a pain-free journey, what qualities both intra & inter-relational are significant in your experience as a caregiver?
What brings you away from being fully present in your work?
In what ways would you like to develop a greater sense of “being at ease in your chair”, when providing face to face care?