Therapists who attend our courses rarely have special training to deal with the emotional reactions of patients. In addition, these patients usually come to us with seemingly physical diseases and complaints.

However, it appears increasingly—sometimes to the surprise of both sides—that a disease which is initially presumed to be “only” physical has a significant emotional basis.

The following considerations and practical information have proved their worth when supporting a patient during intense phases of emotional reaction. They concern reactions familiar to us from reflexotherapy of the feet but which may also be observed in other forms of treatment.

• In order to avoid one-sided fixation at certain levels—“It is all just psychological” or “My illness is definitely only something to do with my stomach”—we should view any kind of pathological process from an understanding of correlations and less on the basis of intellectually fixated causal links. Given the complexity of some illnesses, we can rarely establish unequivocally whether “the chicken or the egg” came first. From a therapeutic perspective, this decision is not necessary either, because it does not alter the course of treatment.

• It is more important to recognize spontaneously when more support is needed at a physical level and when at an emotional level, and to be alert to this aspect during treatment.

• In order to avoid being caught offour guard by patients’ strong emotional reactions and being better prepared to deal with these where necessary, we advise asking the following specific questions in the first treatment session as part of the case history:

• Do you have memories of serious life events which placed or continue to place a heavy psychological strain on you?

• Do you have a family history of emotional stress?

• Do you take medication or drugs to stabilize your mental state?

We can thus react more appropriately to situations if deeper emotional connections emerge. Naturally, such “intimate” questions should be asked sensitively.

Patients decide for themselves what and how much they would like to tell us about their psychological condition. However, we bear no responsibility for reactions caused by a patient’s background about which we have not been informed.

The more alert we are ourselves in dealing with our own traumatic experiences, the sooner those being treated will be able to open up to us psychologically. This includes our learning to distinguish,

• what the patient’s actual condition comprises,

• what constitutes our wishful thinking and our expectations,

• what such reactions trigger in us ourselves.

In addition, we can be sure of developing greater certainty in dealing with such reactions as a result of experience and careful observation.

• We should be aware of our own limits in this regard and make these clear if necessary, for example, by providing instructions for further special care if we feel overstretched. In our experience, treatments such as breathing therapy, biodynamic, and other psychotherapeutic methods which incorporate both psychological and physical aspects, lead clearly and comprehensively to the next steps involved in processing central issues in a person’s life.

With strong emotional reactions, we can choose from the following options:

• Apply one or two of our proven stabilizing or Eutonic grips

• Offer something to drink

• Place our caring hand somewhere on the patient that both parties may discern is an appropriate place

• Suggest a different position or stance or sit the patient upright

• Add more covers or offer a hot water bottle.

Bach Flowers Remedy No. 39, known as Rescue Remedy, has also proven its worth (Dr. E. Bach: English physician, who at the start of the last century developed a special branch of homeopathy). One or two drops on the tongue, in the center of the palm or on the sternum, if necessary, repeated a few times, support stabilization.

• In the process of dealing with a topic, patients can always determine for themselves if and when they would like to stop. If we receive a sign that the patient has had enough for the time being, we should try to understand why by asking a suitable question. The answer may, for example, be: “I am frightened that it is bringing up too much” or “This has already happened to me a number of times and until now I have never gone any further”. In addition to respecting this decision, however, we should ensure that the current experience is not suppressed again. We therefore encourage the patient: “Give yourself time and allow yourself to breathe calmly again.” With regard to ourselves, we should make sure that our breathing does not falter either. We can also gently encourage further processing of this experience at a later time.

• The (re-) experiencing of stressful feelings is one way of really processing deep-seated problems. In addition to the emotional reaction, there should be a discussion so that the emotional change initiated does not get “stuck” and is felt consciously. Just the simple question: “How does it feel now?” points in this direction. We assume the role of listener and avoid being distracted by accounts of individual experiences. A discussion, which should, however, be limited in time, also produces a healthy distance from the preceding, usually unanticipated emotional experience.

• If we ourselves feel overstretched or uneasy in the situation which has arisen, it helps both parties if the patient sits up. (Experience from bioenergetics suggests that being in a horizontal position invites the unconscious to go deeper.)

• With severe reactions, it can help to provide a healthy distance by ceasing any direct touching as this may be too indicative of proximity. However, it is worth asking whether continued touching is felt to be helpful. People usually know what is good for them in such situations.

• We should bear in mind that any kind of touch makes interpersonal proximity far more clearly perceptible than eye or linguistic contact because it includes the body–skin threshold.

• For every treatment in which strong emotional reactions occur, a period of subsequent rest is particularly important to enable the emotions to abate. During the subsequent rest period, patients should feel that they are also being cared for in this phase. Some sleep for half an hour or even a whole hour and wake up refreshed and relaxed. A brief concluding conversation can usually provide a sound way of returning to everyday reality.

• Very rarely: If a patient “drifts” within a strong emotional reaction, that is, if contact is lost, we should ask them to open their eyes and keep looking at us and talking to us. Very simple questions are appropriate for this: “Did you have a jacket with you?” Or: “What did you have for breakfast?” Again and again it has proven useful to have one’s own first name repeated clearly audibly several times in succession. The treatment that was started prior to this situation is not continued.

• It will be helpful for us if we maintain our own breathing rhythm and adjust our posture. After coping with such shared experiences, usually unanticipated, we should request professional advice with regard to further treatment.

If a person reacts intensely at a psychological level, it is not because we have done something “wrong.” What appears spontaneously in the other person was already present in them beforehand; we have not caused it but rather provided the stimulus for its expression and potential resolution.