As a therapist, one of the key skills developed over the years is being able to quickly read and respond to signs of distress in the client. The hope is the client will experience an attuned sensitive response that help them feel seen, heard and supported. This has the effect of containment as the person feels emotionally held and can help in preventing the spiralling of distress that may lead to overwhelming sensations of abandonment.
In most situations, the signs of distress are easily read and can often be felt in the therapist if they are well tuned into their client’s experience in the moment.
In situations where there has been past relational trauma, distress cues can be much more difficult to read and may be covered over with behaviour designed to deflect from the distress felt. Cooper, Hoffman, Marvin, and Powell ( 2001) describe these signals as miscues – misleading or contradictory cue used to protect the child ( or later adult) from the pain of having a specific need exposed and/or unmet.
Addressing miscues is at the foundation of therapy work with traumatised adults and children with the hope that an experience of relationship with the therapist, where the underlying needs are met, will help shift towards healthier ways of connecting, particularly around distress.
The importance then of reading miscues and making sense of these and responding to the underlying distress signals is then paramount. In conversation with parents, some of the cues that might indicate underlying unmet needs include:
- Incongruence- smiling when discussing distress
- Disjointed sentences
- Sudden move away from topic
- Physical restlessness- wanting to finish, hurrying
- Long pauses
- Caregiving of therapist
Infants miscues can likewise hide underlying needs. Examples might include:
As a reparative attachment figure (Adshead,1998), the therapist role is to pick up and make meaning of these cues and then act as an affective container (Bion, 1970) that might then be able to meet the unmet emotional needs of parents and children. Ensuring we are able to read and respond to the signals that are different to the cues offered by others in distress situations, becomes critical in the work with these vulnerable families.