Case Study

The Mindful Swimmer

Staying Afloat in the Rough Seas of Relationship

Karen Kissell Wegela
Magazine Issue
July/August 2010
The Mindful Swimmer

When relationships fail, men suffer as much as women, particularly when they’re the ones who’ve been left. Some men struggle with a pattern of being repeatedly left because of their difficulty expressing—or even feeling and recognizing—their own emotions. But when such men come into therapy, typically in a crisis after a partner has just ended a relationship, they have an opportunity to learn not only how to communicate more personally, but also to discover how much they’ve become estranged from their own inner life.

In my practice, I’ve found that therapeutic work with these clients has three parts: helping them recognize when they’re feeling something, coming to understand what those feelings might mean, and discovering how to experience their feelings in a way that enables them to share them, and so connect with others.

As a Contemplative Psychotherapist whose approach combines the wisdom traditions of Buddhism with the clinical knowledge of Western psychology, I find mindfulness and awareness-based techniques especially helpful when working with men who are unable to read their own inner emotional signals. But just teaching them mindfulness isn’t enough—they need to learn how to be mindful in relationship, a skill they can practice only when interacting with others. The therapeutic relationship itself provides the opportunity for clients to find new ways to engage their inner experience, while learning how to truly connect with another person.

Luc came to see me last fall in great distress after his most recent relationship had ended. In his early fifties, he’s a tall, curly-haired, good-looking man, whose blue eyes crinkle when he smiles, which he does often. He’s the co-owner of a successful business and a former public official. An intelligent, sophisticated man, he moves easily in the world.

He said he came to therapy because he was feeling “desperate.” He’d moved to town with his girlfriend Cynthia, but after nearly two years of an on-again, off-again relationship, she’d abruptly cut off all contact. He was shocked by his own reaction: he’d been crying uncontrollably for days. When he wasn’t crying, he ran what he called the “Cynthia movie” in his mind, obsessing about what went wrong, what he said, what she said, and what he could do to get her back.

What Luc hated and feared most of all was being alone, and he dreaded going back to his solitary apartment. At the same time, he knew that if he quickly got involved with another woman, he’d only be repeating the same old pattern—which, obviously, wasn’t working for him.

From the beginning of treatment, I sometimes felt connected to Luc and sometimes completely invisible to him. While he could easily draw me in with entertaining banter, when he talked about his own life and personal issues, it was as if he were talking to himself. He used vague pronouns, and I had to ask questions repeatedly just to understand what he was saying. For instance, at one point in our first session, he said, “It’s been hard.” When I asked what the “it” was, he lit up. “Oh good,” he said. “You’re not going to let me get away with that.” It wasn’t that Luc was trying to mislead me; he’d simply become accustomed to being distanced from his own experience, which was reflected in his language. In that one moment, he looked directly into my eyes, and I felt a sense of genuine connection before he was gone again into his somewhat detached monologue.

In our first few sessions, I asked about his early history and what he knew about being alone. The sixth of nine children, he’d grown up surrounded by others, but didn’t remember much nurturance at home. His mother was, by turns, neglectful and abusive; his father, largely absent. Luc told me that he recalled being dropped off alone on the first day of kindergarten. Early on, he’d learned to be a self-sufficient child, who grew into a self-sufficient man who could handle anything by himself, thank you very much.

I asked him when he’d last seen a kindergarten-aged child. Together we wondered if he’d benefit from taking a look at one. During the next week, he closely observed a group of youngsters on a playground and then reported: “Those kids were really little, really young. I was let loose way too early.” This set the pattern for “homework” assignments: we’d agree on them together after either one of us had made the initial suggestion.

At first, Luc reported on his discoveries from observing the kindergarten playground in a matter-of-fact tone with no discernible affect, which we later came to call “reading the eye chart.” Then, as he continued to describe what he’d seen, he teared up and finally began to sob. He squeezed his eyes tight as tears ran down his face. His breathing was jerky and he became lost in his suffering. As I sat with him, I felt deeply connected with the pain now palpable in the room. It was like sitting with an inconsolable infant: I felt helpless and sad.

In Contemplative Psychotherapy we use the word exchange to refer to the experience many of us have had of feeling like we’ve “caught” another’s emotion, such as anger or fear. A commonly occurring phenomenon, not limited to therapy, exchange reflects the Buddhist understanding that we aren’t really separate from one another, which is supported by brain science research demonstrating that we’re neurobiologically interdependent.

Exchange can be contrasted with countertransference, in which our reactions are based on our own personal history that’s being projected onto the current situation. It’s also different from empathy, which is our ability to imagine another’s experience.

In those first weeks, I introduced Luc to noticing his experience in terms of three traditional Tibetan Buddhist categories of awareness—body, speech, and mind. Body includes sensations and perceptions; speech includes not only speech, but also all forms of expression, including emotions; and mind includes thoughts and images of the past, present, and future.

In cultivating Luc’s awareness of his direct experience, we began with his sense perceptions and body sensations. Sometimes I’d invite him to simply observe what he noticed in his body or ask him to do a body scan. Like many clients, it was easier for him to identify what he could perceive through his senses than what he felt inside his body. Using the sense perceptions—sight, hearing, smell, taste, and touch—became a useful anchor to the present moment.

With practice, he got more skilled at tracking his inner-body experience, though, at first, all he could notice was tightness in his chest and throat. We agreed that he would, from time to time, practice tuning in to his bodily experience when he was home alone. This proved to be far more difficult than either of us expected, because he tended to fall into mindlessness practices right away—continually rerunning the Cynthia movie, smoking cigarettes, biting his nails, even occasionally drinking alcohol—that distracted him from being with himself.

He began reading books as a less harmful mindless practice. Among these was a book on mindfulness meditation, and Luc followed its various exercises diligently. I soon recognized, however, that he was using these practices as a way of shutting out his emotions. For example, when thoughts or feelings arose while he was focusing on his breath, instead of acknowledging them and letting them pass without judgment, he’d actively push them away by forcing himself to concentrate solely on the sensations of breathing. As a result, his practice didn’t cultivate unconditional mindfulness, but further strengthened his mindlessness.

In our sessions, Luc’s speech reflected his feeling of disconnection with himself and with me. For example, he’d refer to himself in the second or third person. “You’re home alone and what’s there to do? You just end up smoking cigarettes and thinking about Cynthia.” I taught him the Gestalt technique of replacing “you” and “it” with “I.” “When I’m home alone, I don’t know what to do. I end up smoking cigarettes and thinking about Cynthia.” He was delighted to be able to catch himself being mindless and found this a useful and simple tool, not only for bringing mindfulness to his speech, but for experiencing his feelings more directly. Unlike some clients who might have become defensive, Luc was genuinely curious and interested in tracking his own mindlessness.

Having learned early in life to be ready for harm from his abusive mother and from the nuns at his school who practiced corporal punishment, Luc was highly attentive to the details of others’ behavior and facial expressions. Hyperalert, he compared himself to a rabbit with large ears—always scanning the environment for possible threats. He’d been able to keep his various failed relationships going for as long as he had by paying attention to what his partner wanted and doing his best to provide it: financial support, attentive listening, sexual passion. Sooner or later, however, his own emotional absence had driven his partners away.

However, no one’s emotional patterns are monolithic. We all have natural wisdom within us, or what Contemplative Psychotherapy calls “brilliant sanity”—comprising inherent wakefulness, compassion, and panoramic awareness—which emerges, if only fleetingly, in everyone from time to time. As Luc began feeling safer in our relationship, he’d ask me what a particular change in my facial expression meant, and I’d generally answer truthfully. If I felt sad—as I often did with him—I’d say so; if I was spacing out, I’d share that.

Over time, as our work expanded from attending to physical sensations to including emotions, Luc would close his eyes and identify feelings, which he said he still didn’t do when he was alone. In one session a few months into our work together, after exploring his sadness about Cynthia more, he described a potent image. “It’s like I’m drowning in the sea and any buoy will do. Cynthia wasn’t a great buoy, but she was better than none.” As he said this, he felt an intense fear, and began to weep. Sitting with him, I experienced nameless terror, an experience that I believe was exchange.

Sometimes, when we experience exchange, we feel just as lost and confused as the person we’re sitting with. In whatever way an experience arises, it’s still up to us to work with what’s now our own, however. Because of many years of meditating in all kinds of states of mind, I was able to stay present and grounded in my body and feelings as Luc contacted his fear, but it was difficult. Like him, I didn’t have a story to explain these intense feelings in the moment. In retrospect, I could see that I’d glimpsed the pain he was doing his best to avoid. We can never be certain that an experience arises from exchange, but knowing about exchange opens up possibilities to explore with our clients.

As he’d begun to describe his sadness, Luc had been, as usual, out of touch with me even as he was in touch with his own painful inner experience. After a while, once his crying was spent and he’d described his own experience to me more fully, I shared with him what I’d felt. As he listened, nodding and acknowledging that what I described was the sort of terror he’d felt, we shared a sense of genuine connection. He looked directly at me, his face relaxed, and I had a feeling of being met.

This lasted a few minutes before he started on another story, and we both noted this shift. Then Luc came up with what became a powerful metaphor for him. “Maybe I could learn to swim,” he said. “Then I could swim both by myself and with others. I wouldn’t have to drive Cynthia and others away by hanging on so desperately.” In our work together, we continued to use the idea of learning to swim—becoming able to be with himself, without having to find distraction, even when he was alone.

Luc and I then started to work with identifying and re-owning the feelings and thoughts he projected onto others, especially onto Cynthia. For example, one day he was listing a number of things he viewed as being wrong with her. “She’s so pathetic. She lives behind a wall. Behind that wall, she’s a perfectly OK person, but she doesn’t know it. I can see how good she is, but she can’t.” I invited Luc to try on these attributions as projections—to experiment with saying about himself, using first-person pronouns, what he’d been saying about Cynthia. I explained that often we attribute to others thoughts and feelings that we’d prefer to ignore in ourselves. I suggested he try it and see whether anything he said felt like it fit his own experience.

In his “eye-chart” voice, he began, “I’m pathetic. Yeah, I can see that.” I encouraged him to try on the other things he’d said. “I’m behind a wall. OK. Yeah, I recognize that one. Oh, I don’t know about that next one. I’m a perfectly OK person, but she doesn’t know it.” I quietly corrected him. “Oh. I’m a perfectly OK person and I don’t know it. I’m good but I can’t see it.” The eye-chart voice cracked as he let that in. In that moment, I could see and feel a shift. He teared up, but, this time, it was tender sadness, containing some insight into his own situation, not the blind anguish of a bereft child. He was able to look at me and stay connected. Our eyes met and his face remained soft. As before, this lasted only a brief time before it faded.

In the next weeks, Luc continued to explore re-owning the thoughts and feelings he’d projected onto others. He discovered increasingly that he could feel his feelings and tolerate their intensity; he could even sit quietly at home, recognizing what he was feeling. He became aware of his sadness, anger, and fear. More often than not, however, he still withdrew into himself when he actually felt his feelings with me. Staying in contact with me and simultaneously feeling his inner experience was extremely challenging because he still was afraid to feel his feelings with another person, even me.

Around this time, he began to do some volunteer work with the disabled. He practiced noticing his projections with the clients and with his co-volunteers. For example, in working with an autistic boy, he said, “He doesn’t even know I’m there.” I asked him to try this one on as a projection. “I don’t even know I’m here,” he said. “Or maybe, it’s I don’t even know you’re here.” This gave us the opportunity to explore more deeply how he cut himself off from me.

One co-volunteer, in particular, Rachel, piqued his interest, and he noticed his habitual inclination to entice her into a relationship. They’ve begun a friendship, and Luc is monitoring things as they develop. He hasn’t yet started a “Rachel movie”—a video constantly running inside his head, with commentary about their interactions—but he’s fully aware that he could easily fall into that old habit.

At this point, he’s made significant progress in bringing mindfulness to his sensations, feelings, thoughts, and images. Increasingly, he can tolerate emotional intensity. The more he can do this, the less he’ll be tempted to latch on to a relationship as a way of escaping from being alone. He’s begun reaching out to others and bringing more of himself along. This is true of his relationship with me and somewhat so with Rachel.

He sees that he still has a ways to go, but he has a sense of movement and progress. “I feel like a woman I once saw skiing,” he said recently. “She was blind and being helped by a ski instructor. She couldn’t see anything, but was tethered to him. I imagine she was scared and shaky, but also determined to do it. It couldn’t have been any fun. That’s exactly how I feel.”

“And how is that for you right now?” I asked, expecting to hear him say something about his fear and discomfort.

“I feel like I’m in an all-white room, and I’m kind of amorphous and white myself. The floor is all eggshells. I’m not very comfortable, and I feel really vulnerable. I can’t see where I end and the room begins.” Here he paused for a long time, then looked directly at me and said, “But I’m really OK with that.”

I believed him. He really was OK with it. For perhaps the first time in his adult life, Luc was able to tolerate emotional intensity, as well as the painful uncertainty and vulnerability that arise when we try to break long-engrained habits developed in our early years to protect us from suffering. Although our work isn’t complete, my hope is that Luc’s increasing mindfulness of his inner life can allow him to engage more fully in relationships, including perhaps the sort of close and caring relationship he longs to have one day with a life partner.


Case Commentary

By David Treadway

Karen Wegela’s work with Luc is delightful. She clearly “gets” what the Networker referred to in its May issue as “the secret world of men.” Men aren’t withholding from their intimate relationships exactly; it’s more that they aren’t in an intimate relationship with themselves. As one of my grizzled A.A. veterans said to me once, “You know, Doc, you don’t know what you don’t know.” That sums up many men’s experience—or lack of experience—with their emotional life.

As I read through this piece carefully, I discovered some startling parallels between myself, Luc, and many of the men I treat. I can remember vividly early on in my 42-year marriage when my wife, Kate, would say things to me like, “I just don’t feel like you’re really here.” I didn’t know what the hell she was talking about! It took me a long time to recognize how cutoff I was from my feelings because, as a therapist, I was in the feelings business—other people’s feelings. Later on, I recognized that I really was missing in action, and I began to refer to my coping style in the words of the Southern California postcard, “Having a great time; wish I was here.”

Wegela projected profound empathy for Luc and a deep understanding that his difficulty was that he didn’t know how to be in relationship with himself, nor did he know how to be in relationship with himself and someone else simultaneously. As a professional codependent, I’m painfully aware of that dynamic—I’m skilled at losing myself through caring for others. I’ve known how to fully connect to myself when I was alone, but the challenge of being fully connected to myself and another at the same time has been difficult.

With Luc, Wegela utilizes directed mindfulness training to help him become self-aware, able to tolerate his affective intensity, and, most important, simultaneously connect to her, even when she was expressing strong feelings. The challenge for most men is to be open to the emotional intensity of their intimate partners, rather than to clam up and try to fix or manage the feelings that come up for either one of them.

Wegela skillfully uses the therapeutic relationship to help Luc learn how to bring affectionate curiosity to his and her experience. This is the heart of therapeutic mindfulness. It’s the heart of good relational therapy. It’s a pathway to intimacy.

Ah, Karen, by the way, do you do phone consults?


Karen Kissel Wegela, Ph.D., has been a professor at Naropa University since 1981, where she teaches Contemplative Psychotherapy. She’s the author of The Courage to Be Present and How to Be a Help Instead of a Nuisance: Practical Approaches to Giving Support, Service, & Encouragement to Others.

David Treadway, Ph.D., is director of the Treadway Training Institute. He’s the author of Home Before Dark: First Year with Cancer and Intimacy, Change, and Other Therapeutic Mysteries: Stories of Clinicians and Clients. Earlier books include Dead Reckoning: A Therapist Confronts His Own Grief.