In a previous post, I Introduced validation. I reviewed what validation is and is not, and why it is an important therapeutic skill. This week I’ll be going over the “hows” of validation. Specifically, therapy basics of paying attention and using reflective statements. I’ll also cover next level skills of transparency, anticipating needs, cheerleading, and more.
Clearly Be Paying Attention
This may seem like an obvious one; for the most part it is. However, it still bears reviewing. We are only human. Despite our best efforts, we will have days where our mind wanders, where we have to work harder to stifle our yawns, where our anxiety is getting the best of us and our knee is bouncing more than normal. Some of our clients, particularly those diagnosed with borderline personality, can be exquisitely sensitive to shifts in behavior, demeanor and attention. Often, they are accurate in their observations, and interpretations of those observations is where things can get dicey.
So what do we do? The goal is not to become a robot. Rather we aim to become more aware, more intentional, and more humble. With our awareness and intentionally, we can actively seek to communicate that we are listening. If you usually take notes in session, this may mean putting your notepad down. Other times we use our body language to communicate that we are paying attention, by changing our posture, leaning forward, and making clear, gentle eye contact. In the world of telehealth, the nuances of this can look a little different. And the temptations for distraction are even more. In person or in telehealth, if you do get distracted or can’t stifle that yawn, own it. Model that being human is ok and even in your imperfections, you are still showing up and caring. And process the experience with your client, being sure to only validate the valid!
Use Reflective Statements
We can also be validating through use of reflection statements. This is therapy 101. The classic statements of “What I’m hearing is… “ This demonstrates that we are listening and it offers the client the opportunity to clarify or correct. Such an exchange can help minimize miscommunications. We also want to apply this to our client’s non-verbals. “I notice when I mention X, you end up holding your breath, are you aware of that? What do you think that’s about?” We can also use reflective statements by explicitly stating what makes sense. “It makes sense that you hold your breath every time I mention X because of what you shared with me earlier.” In doing so, we are demonstrating that we are attending to and understanding them through our conceptualizations.
Next Level Skills
There are also more nuanced ways to validate by anticipating needs, being transparent, using segues, making decision-making collaborative, and cheerleading. There is some overlap to these concepts, for example we might be transparent about why we are segueing to a different topic because we can anticipate that it might seem like a jarring switch to our client, or that they might be apprehensive about what we are going to address next.
Transparency
I previously talked about transparency in the context of trauma-informed care. Transparency is labeling what you are doing and why. If a client feels uncertain about why you are asking the questions you are, they are more likely to be on edge and more likely to expect a threat in the form of criticism, invalidation, etc. Telling the client what you are doing eliminates the guesswork, it also allows for buy-in to get more collaborative in the process.
Anticipating needs
I first learned about this concept while waitressing. If someone orders a hamburger, you bring ketch-up and mustard out with the burger, you don’t wait to be asked for it. This demonstrates knowledge of the common preferred way to enjoy a hamburger, makes the customer feel taken care of, allows them to dive right into the burger versus waiting for you to come back with the desired condiments, and it saves you a trip. Win-Win.
What does this look like in a therapy setting? It means using your understanding of your client to anticipate they might need extra explanation to trust your next question. It means using your conceptualization to label that you know what you are going to ask them to do may piss them off!
For example,
- “I’m going to do that annoying therapist thing again.”
- “Hang on, stay with me, I know this is hard. Why do you think I’m asking you to look at it a different way?”
In the first example, using this bit of humor can go a long way. Having done it enough, the client gets to know you and responds with “Yea, yea, yea, I know just out with it.” In the second example, I’m inviting the client to think critically and join with me. I’m reassuring them I’m doing what I’m doing for a reason, not just to be obnoxious or make them feel bad.
Label Difficult Emotions
Another way we can anticipate needs is by being the one to label the presence of difficult emotions, particularly those that make it hard to connect in the moment. One such emotion is shame.
By definition, shame makes us want to hide and can be painful to acknowledge.
To avoid such escalation, I may preemptively label that shame may get activated (once this concept has been introduced in care and the client is ready to engage with it) AND very intentionally and truly genuinely, label and VALIDATE how difficult the work is they are doing both in terms of challenging the shame and engaging in painful self-reflections and doing the unbelievably hard work of pursuing change. And I meant it when I said it. I’m not blowing smoke and I’m also not being patronizing. I am stating it as a fact; I am validating the valid, the truth of this experience, which is that change is hard.
Cheerleading
This sort of validation is also a form of cheerleading – finding the smallest of wins and celebrating their significance. A massive win can be having a client able to recognize the activation of shame and willing to label it. And that’s huge! Much of our work in therapy takes time. Change is often slow. Celebrating the small moments, validating each and every step towards progress helps sustain hope and motivation.
As you know, I enjoy my pop culture references….for cheerleading, I always think of Ted Lasso. And with that joyful moment, we’ll wrap up here for today!
For Clinicians: Validation can seem like an easy and obvious skill. And, I would argue, it really is an art form. There are subtle ways to validate wherein the client might not even consciously label that they felt validated in the moment. Rather it is experienced as the quietness of safety and the confidence of being heard that allows them to keep talking, keep processing, and keep healing.
For Those Seeking Care: Feeling heard, understood, and validated by your therapist is important. And remember validation is different from agreement and reassurance!
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