Recognizing Emotional Masking in Therapy: A Therapist's Perspective

As a therapist, one of the challenges we face is identifying when a client may be masking their true emotions. This can be particularly difficult if the client is doing so unconsciously. This article explores the signs of emotional masking, strategies for recognizing it, and the importance of incorporating family insights in the therapeutic process.

The Complexity of Emotional Expression in Therapy

Every individual, in every situation, manages their emotional expression in unique ways. When a client sits across from a therapist, it is important to accept and respect what they are willing to share at any given moment. Judgments about the accuracy or adequacy of these feelings are best avoided as they can hinder the therapeutic process. Accurate empathy requires that we work with the information our clients voluntarily disclose. Yet, there can be instances where this facade does not accurately reflect the client's true state.

Case Study: A 20-Year-Old Client

A therapist once worked with a 20-year-old client who entered the session very slowly, with small, deliberate steps. She greeted the therapist with a pale smile, sat on the opposite side of the room, and quickly glanced at her feet while answering questions with monosyllabic responses. Further probing revealed a stark contrast between her behavior and her expressions. What stood out was the marked discrepancy between her self-report and her reported behavior. Her family reported that she had not left her house in 10 days, had not eaten properly, and had been locks herself in her room, barely meeting her basic hygiene needs.

This case illustrates a clear discrepancy between verbal and non-verbal cues. The client’s actions and the report from her family provided strong evidence that she was masking her true emotions.

Recognizing Emotional Masking

Therapists often rely on a combination of clinical judgment and family insights to determine if a client is masking their true emotions. Key indicators might include:

Stiff or guarded body language Monosyllabic or preserved monologues Short or evasive answers to direct questions Difficulties with eye contact or avoiding eye contact Inconsistencies in reported symptoms or behaviors

Integrating Family Insights

Family involvement can provide crucial context and validation for a therapist’s observations. Families often notice patterns and behaviors that may not be apparent to the client or the therapist alone. For example, the family might report significant changes in eating, sleeping, or social behavior that the client may not acknowledge. These insights can help the therapist understand the client's emotional state more comprehensively and formulate an effective treatment plan.

When to Bring It Up

Determining when and whether to bring emotional masking to the client's attention is crucial. Factors to consider include:

The urgency of the client's situation The client's readiness to explore these issues The potential impact on the therapeutic relationship

It's often most effective to address these concerns indirectly at first, using family observations to validate the therapist's concerns and foster a collaborative approach. As the client becomes more comfortable and feels supported, the therapist can encourage the client to explore these issues more openly, ensuring that the client feels heard and understood.

Conclusion

Recognizing emotional masking in therapy is an essential skill for any therapist. By understanding the complex interplay between verbal and non-verbal cues, and by leveraging family insights, therapists can better understand their clients and provide more effective, personalized care. The ultimate goal is to support the client in uncovering and addressing their true feelings, fostering healthy emotional expression and recovery.