Labels and the Therapeutic Relationship

A therapist writes "depression" on a paper attached to a clipboard while a client sits in front of him with his hand on his head.Before we go further into the theory underlying Core Energetics, Core Evolution, and other body-psychotherapies, I want to discuss the therapeutic relationship. This is a subject I feel very passionate about!

We use labels to try to understand something or to communicate about our experience. Sometimes people come in and repeat to me what other therapists have told them. They may have a page full of western mental health diagnoses or they might say, “I am a rigid psychopath.” The latter refers to labels given to holding patterns way back in the time of Wilhelm Reich. These holding patterns also lead to personality traits, or what Reich called character structure. While still respecting Reich’s very important work, Core Evolution no longer uses these labels in this way. However, many practitioners still do.

The holding patterns will be the subject of future articles, but today I want to talk about how a person would come to own such a label, and if it could have any value to them. Often people will read a book and label themselves, although they may be trying to understand their experience, this may be an intellectual exercise, an idea they have in their head based on someone else’s experience or knowledge. The problem is that the label doesn’t describe what actually happens. The labeling can be limited in that the person may not really know, kinesthetically, what it means. It can also limit the wisdom of the body, the mind, and the emotions’ ability to have new experiences, obfuscating the change process.

I strongly believe that therapy is co-created between the client and the practitioner. While a therapist needs to have a solid theoretical groundwork that guides how s/he understands what happens in the sessions, its function is to provide a map for the work. I hope to use my knowledge in a way that provides a structure for understanding the therapy, rather than dictates a person’s experience.

I am aware that I cannot assume to understand the experience of another. Therefore, we need to stay in constant communication, exploring and bringing into awareness what is happening for the person in their mind, body, and emotions each step of the way. This information helps the person to see how they do whatever it is they do in their life, and gives me information to guide the session. Awareness of what we do internally, how we structure our energy, and how it affects our thought patterns, feelings and behaviors, is a large part of what creates change.

A big reason that I employ physical exercise that can be provocative in groups and in sessions, is to open the system and help the person to explore beyond their normal experience and holding patterns. The things that come up during the session define where we go next. A recent group session encouraged members to explore what happens in their body under certain conditions. For example, if you have “been left by someone you love” or if you have “been falsely accused,” How do you respond? We explored the attitudes “I can do it” and “I will not them get me.”

Members were able to perceive their reactions in their bodies, the posture and the muscular and breathing patterns that ensued. They were able to identify the familiar attitudes that they personally carry through life, recalling the memories that created these reaction patterns. We walked around the room exaggerating the posture of this attitude and were able to see how the attitude was received by others and how we were affected by others’ attitudes. This type of exercise creates a solid foundation of experience to recognize reactions going on within themselves and in their dynamics with others that had, until now, been out of full conscious awareness.

We are constantly exploring and tuning in so that participants have a way of recognizing when they are reacting to old belief systems and patterns based on past experience, rather than what may actually be happening in the here and now. Along with other preparation provided in the therapy, this self-awareness can set the stage for new experience and different reaction patterns.

On the contrary, if I were to tell you what (I perceive) you do, what the clinical name is for it, and how you may have come to it, this could, in the best case scenario, be a great relief to you because it can normalize your experience and give you some self-understanding. But, even if it accurately describes your reaction patterns, it would be limiting because if it remains an idea or a concept. You will not have the awareness to know how it is triggered, the mind-body awareness to know when it is being employed, or the compassion for your system that will help you to change it in the moment.

You may end up believing you are a victim of your physiology, clinging to the label rather than encouraging and allowing the innate knowledge of the system to find its way to a new repose. It is so important to realize that reactions come from experiences, and even though they then become patterns, this is not who we are at the core. When we identify with the reaction patterns and the labels we use to describe them, we are very likely to reinforce the problem and to become stuck.

We have created a mental health system where labels are important for identifying the problem and for reimbursement purposes, but it is essential to not let that lock a person and their practitioner into a way of working that 1) gives the practitioner power over the client by assuming s/he knows more about the problem than the client; 2) limits the exploration of the problem and the treatment process based on the label and the idea that we are our labels; 3) causes the person to identify with the label and the past experience, rather than use it to facilitate change. We must be creative in the work and seek to find the deeper wisdom of the situation at hand.

© Copyright 2010 by Aylee Welch, LICSW, therapist in Seattle, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Andrea


    January 4th, 2010 at 9:50 PM

    Ooo…I didn’t know the newsletter articles were blog articles as well. This is great!

    “We have created a mental health system where labels are important for identifying the problem and for reimbursement purposes”

    In light of my own recent “reimbursement experiences,” this line made me snort out loud with the irony. Even though labels were used long before health insurance was invented, it seems the latter has superceded the former at times.

  • Clayton J.

    Clayton J.

    January 5th, 2010 at 9:56 AM

    It is very important that both the practitioner and the client work in tandem to understand the situation and find a suitable solution to it. If any one feels that he does not need the other one’s input, the session is a complete waste. It requires team work.

  • Maggie W

    Maggie W

    January 5th, 2010 at 10:34 AM

    I feel very strongly that sometimes the overuse of labels in life makes for some terrible experiences. We spend all of our time too concerned with what lables things and relationships are wearing and trying to live up to that instead of simply dealing with the reality of the situation. The fact of the matter is that labels can be so harmful yet there are very few times that we recognize and deal with the angst that they can cause until it is too late. I would be very adverse to dealing with a therapist who only chose to label me instead of working to help me get to the root of the problem. Too often society totally feeds in to this and really it typically does nothing except to make a situation worse. Why not stop with the labels and take each individual situation on its own relevance, and not based on what we think it is or should be.

  • Carolyn


    January 5th, 2010 at 6:05 PM

    I can’t agree with you more about labeling. Labeling and even seemingly neutral words can inhibit the exploration of physical and emotional feelings that allow us to evolve and change. A word or label may attach us to some social group so that we feel that we “belong”, but it can be a false sense of belonging and can lead to stagnation rather than growth. It’s really tough to avoid labels, but I find I relate with more curiosity and empathy to myself and my fellow human beings without them.

  • Aylee Welch, LICSW

    Aylee Welch, LICSW

    January 7th, 2010 at 10:17 AM

    I appreciate all of your comments and it makes me realize that even in the best intention of using a label, it becomes outdated because it is not fluid and changing. This is also true of a body’s defense mechanism. It utilizes a strategy that protects it in a given moment. Later something that reminds the body of the first event triggers the same response but it may not be the same situation at all but we don’t have the fluidity and flexibility to check this out because it is already coalesced into a belief system that keeps us in certain life patterns. The analogy may seem to be a stretch but the point is to always be asking, does this (label or reaction) fit what is happening in the here and now. As for the insurance industry, Andrea, it is certainly outdated and not functioning at its best these days!

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