Is It Experiential?

1 day ago

7 min read

Updated: 6 hours ago

Why every therapy session is already an experience—and why the more useful question is what the patient is already practicing.

David M. Rudesill, LCSW

The clinical illustrations below are composites. Identifying details have been omitted or changed to protect confidentiality.

In response to asking what a supervisee wanted my help with when reviewing their clinical work, they responded, “Is what I'm doing with the patient experiential?”

I think I understood the implicit question immediately: “Is it emotional?”

In experiential psychotherapies, the word experiential can gradually become shorthand for a particular kind of dramatic event: a patient begins crying, anger rises in the body, grief breaks through, or a long-buried feeling suddenly becomes unmistakably present. These are powerful moments and easily validate all that hard work and training herapists go through. They can also lead therapists to imagine that therapy alternates between experiential moments and… everything else—as though the “real work” begins only once a recognizable feeling arrives.

But therapy is always experiential. Because life is always happening.

A more useful question may be:

What is the patient experiencing right now?

Are they experiencing anxiety-laden emotions towards someone they love? Is their anxiety rising beyond their capacity to think and reflect? Or are they experiencing—and rehearsing—one of the behavioral or psychological strategies they habitually use to escape feelings, anxiety, closeness, conflict, or personal agency?

There are no psychologically neutral moments in the consulting room.

Feelings Are Not the Only Experience

A patient may be experiencing mixed feelings: love and anger toward the same person, longing mixed with fear, grief entangled with guilt, or tenderness complicated by resentment. When those feelings can be tolerated within the patient’s working capacity, therapy can help them experience a fuller and more integrated emotional reality.

A patient may also be experiencing greater self-connection. They may recognize, perhaps for the first time, “This is what I want,” “This is what I feel,” or “This is the choice I am making.” They may remain emotionally present with another person without immediately accommodating, withdrawing, attacking themselves, or surrendering their own point of view.

Sometimes the patient is experiencing anxiety that has risen beyond a useful threshold. Their body may become overwhelmed, their thinking may become less clear, or they may become detached from the interaction. Pressing harder towards the experience of emotion in that moment does not necessarily make the therapy more experiential. It may simply give the patient another experience of becoming flooded, losing access to themselves, and becoming overwhelmed in a relationship.

Oftentimes what the patient is experiencing is defense.

For example, they may be experiencing themselves:

telling an elaborate story instead of relating the essence of it;
analyzing their feelings instead of feeling them;
waiting passively for the therapist to provide direction or “tools”;
trying to give the “right” therapeutic answer;
attacking themselves when they cannot meet an imagined expectation;
speaking about themselves as though they were another person;
or saying “I don’t know” immediately after revealing that they do know.

These are not periods in which nothing is happening. These are highly active psychological events.

“I Know"—followed by “I Don’t Know”

Consider a patient who begins to approach a personal truth:

“Maybe, deep down, I actually do know what I want.”

Then, almost immediately:

“I don’t know.”

The patient has just had an experiential moment.

They momentarily experienced knowing—and then undoing their knowledge with a defense.

Perhaps knowing what they want creates anxiety because their wish differs from what someone important wants. Perhaps clarity threatens a relationship organized around accommodation. Perhaps saying “I don’t know” restores a familiar state in which someone else becomes responsible for deciding.

The therapist does not necessarily need to interpret the entire pattern. A simple observation may be more useful:

“You just said that you do know what you want, and then you immediately said you don’t know. Do you notice that?”

Now the patient has a new experience: not merely performing the defense but observing themselves performing it.

Repeated experiences of this kind can gradually make a previously invisible behavior (defense) more visible to the patient. The patient begins to move from:

“This is simply who I am.”

toward:

“This is something I do.”

And eventually:

“Is this something I still want to do?”

Patients Are Always Getting Better

One of the more helpful ways we can think about psychotherapy is—thanks to Jon Frederickson for passing along this pearl:

Patients are always getting better. The question is, what are they getting better at?

A patient may become better at noticing anxiety before it overwhelms them. They may become better at tolerating mixed feelings, asserting a preference, remaining emotionally present, or allowing another person to know them.

But repetition also strengthens defensive pathways.

A patient can become better at intellectualizing and ruminating. Better at disappearing and hiding into stories. Better at waiting for someone else to provide motivation. Better at pleasing the therapist. Better at turning emerging clarity into confusion. Better at attacking themselves whenever they feel uncertain. Better at relating to imagined versions of other people rather than the real person in front of them.

This is not a moral judgment. It is a recognition that human beings learn through repetition—Hebb’s law.

The therapy relationship is continually strengthening something, experiencing something.

If a patient repeatedly waits for direction and the therapist repeatedly supplies it, the patient may become even better at experiencing another person as the driver of their life.

If the patient gives a vague answer and the therapist repeatedly fills in the meaning, the patient may become better at remaining unclear while another person thinks for them.

If a patient speaks brilliantly about emotions while remaining disconnected from their body, and the therapist primarily engages the brilliance of the explanation, both participants may become better at having intellectually sophisticated conversations that leave emotional isolation untouched.

The question is not simply whether the therapist made a technically correct intervention. It is:

What capacity is this interaction strengthening?

The Consulting Room Is Not a Separate Universe

A patient’s life and the therapy room are often separated by little more than a flight of stairs, a hallway, and the drywall of the consulting room.

The person does not magically become psychologically different when the session begins. We’re not in Narnia.

What patients do and experience in therapy will usually reflect what they do and experience elsewhere.

The person who cannot identify their own wishes in a relationship may ask the therapist to determine the goals of treatment.

The person who chronically accommodates authority may agree with every interpretation while remaining internally unconvinced.

The person who fears criticism may hear an observation as an indictment.

The person who waits for others to initiate may sit in therapy hoping the therapist will “get things going.”

The person who abandons their own preferences to preserve closeness may begin to study what the therapist wants and become that kind of patient.

The person who manages anxiety through analysis may provide an impressively coherent account of their difficulties while remaining emotionally far away.

These patterns are not interruptions of therapy. They are the patient’s life occurring in the therapy relationship.

The therapy room gives us an unusual opportunity to slow the pattern down enough that it can be observed.

Who Is Driving?

Suppose a patient says they function best when someone gives them advice, pushes them, or tells them what to do.

On the surface, this may sound like a reasonable request for a more directive therapist. Sometimes structure is helpful. But we should also become curious about what is being enacted.

Does this patient routinely let other people define what matters to them?

Do they become productive when pursuing someone else’s goals but lose contact with their own passion?

Do they feel resentful when others take control, while simultaneously inviting others to take control?

Do they experience themselves as incapable of moving unless another person supplies the motivation?

If the therapist simply accepts the invitation to drive, the patient may feel temporarily relieved. Yet therapy may also reproduce the very problem that contributes to the patient’s depression, passivity, resentment, or lack of self-knowledge.

The therapist’s task is not necessarily to refuse all guidance. It is to notice the relational meaning of the request:

“You are asking me to take the wheel. Is that similar to what happens elsewhere in your life? What happens to your own wishes when another person becomes the driver?”

That is an experiential intervention because it brings the patient’s actual relational pattern into view while it is happening.

Experiential Does Not Mean Dramatic

The depth of a therapeutic experience cannot be measured by its volume.

A patient may cry intensely while remaining defended against the mixed feelings at the center of their conflict. Another patient may quietly notice that they habitually erase their own preferences, and that small observation may reorganize how they understand years of depression.

A vivid emotional portrayal is not automatically therapeutic. A calm conversation is not automatically intellectualized. A patient’s anxiety may indicate meaningful emotional mobilization—or it may be too high for useful reflection. A patient’s apparent calm may reflect genuine regulation—or detachment, passivity, compliance, or emotional distance.

This is why precise moment-to-moment psychodiagnosis matters.

What happened after the intervention?

Did the patient become more connected with themselves?

Did anxiety rise within a tolerable range?

Did they become clearer about what they felt or wanted?

Did they become more active and agentic?

Or did they become more passive, confused, compliant, detached, or dependent upon the therapist’s understanding?

The patient’s response tells us what kind of experience is occurring.

Helping Patients Experience Their Defenses

Patients often need to experience a defense many times before it becomes sufficiently visible and uncomfortable for them to consider changing it. One of my trainers referred to it as “parking on the defense.”

The therapist may need to point out, gently and repeatedly:

“You knew what you wanted, and then you undid it.”

“When I asked about you, you began explaining someone else.”

“You are waiting for me to decide where we should go.”

“You started to feel something and then moved into analyzing it.”

“You are imagining what this would cost another person, but you have not yet considered what it costs you.”

The purpose is not to catch the patient, defeat the resistance, or prove the therapist’s insight.

It is to help the patient become present for something they usually do automatically.

Once the patient can see the defense, they may begin to understand its function. Once they understand its function, they can examine its cost. Once the cost becomes personally meaningful, a genuine wish to change may begin to emerge.

That process is experiential even before a major emotional breakthrough occurs.