Dealing with Angry Ghosts in Psychotherapy

Though many therapists are trained to believe that they need to suppress or control feelings of anger, I think it is incredibly important to use them in therapy because they often reveal important patterns in the patient’s life--ghosts of relationships past. When these feelings go unexamined, they can harm the patient because they can slip out in hurtful ways. But, when examined, they can be some of the most healing moments in therapy.

Below are ways a therapist might use the anger. I tried to organize them from the most immersed in the enactment of the relational pattern to most reflective, liberated and healing.

  1. “You’re such an asshole”
    This is obviously the most aggressive enactment.  The therapist has no reflection and is merely attacking the patient in turn.
  2. “I’m feeling angry at you, what are you feeling?”
    This is at least being reflective of the therapist’s own reaction and inviting the patient to reflect on their own feeling. The problem is that the patient can often feel defensive just because the therapist admitted anger at the patient.
  3. “I feel like you are angry at me. Do you feel that way?”
    This is trying to be reflective but it’s only about the patient’s experience and in fact it’s pretty judgmental and assumptive. The patient is prone to defensively say, “I’m not angry! I’m just…” It’s also problematic because the therapist isn’t acknowledging the role they might be playing in the interaction.
  4. “I feel like we are about to take turns being angry at each other because I feel the need to defend myself.”
    This is interesting because it acknowledges that both parties are involved and begins to illuminate the functional purpose of anger, inviting the more vulnerable feelings that anger often protects.
  5. “I think I feel hurt by what you are saying, which is making me want to defend myself by attacking you back. What’s going on with you?”
    This explicitly names vulnerability on the therapist's side but can feel very risky because the patient may feel burdened by the therapist's reaction. The therapist will need to watch for this and address it quickly.
  6. “Can we talk what’s going on between us? I feel something very palpable happening. How would you describe what is happening? What are you thinking or feeling about us or me?”
    This is the most inviting and collaborative way to start. But, it’s also very wordy and socially unusual. Before this moment, hopefully the therapist has prepared the patient for moments like this. If the patient doesn’t think anything is happening, then the therapist might use the levels above to share what their own experience.

It’s okay for therapists to find themselves reacting or enacting from various levels, though maybe not calling someone an “asshole.” It’s so important to reflect on and metabolize difficult relational moments in therapy. These kinds of enactments are unavoidable. These ghosts seek liberation, consolation, or at the very least understanding.