Imagine Your Enemy

95% of our problems talk back – Anonymous

Think of someone you don’t get on well with.

Just imagine for a moment that they are there with you right now.

What happens?

Did your stomach drop and your heart sink?

You are not alone.

In 1988 Dr Tom O’Dowd wrote a paper¹ in which he coined the term ‘heartsink patient’ for some of the challenging patients doctors see, he described the symptoms as the feelings felt in the pit of your stomach when the patients’ names are seen on the morning’s appointment list’.

In the lives of our clients (and perhaps our lives to) there will be ‘heartsink’ people whom they find challenging.

Perhaps it’s something these problematic people say, how they look, their tone of voice or ‘vibe’ that triggers our clients into defensiveness, powerlessness, fear, anxiety, anger or any other unhelpful emotional response.

Sometimes, when our clients think about such people, or imagine being with them, it can make our clients feel bad.

Changing our client’s unhelpful responses to these people could be very useful, but how can we do that?

We can hardly bring our client’s problem person (people) into the session with them because that would freak out the client and be kind of weird for the other person.

Fortunately, we don’t have to bring in the real person because our clients already have imagination.

Remember in the ‘heartsink patient’ quote, the symptoms were the “feelings felt in the pit of your stomach when the patient’s names are seen on the morning appointment list.” The patient didn’t even have to be in the room, just imagining them made the doctors feel bad.

We can use that same phenomena to help our clients (without exposing them to the problematic person, in person).

Just having the client imagine that ‘other person’ will probably provoke the responses that need to be soothed by tapping.

IMPORTANT If the client’s response to this person is the result of past traumatic experiences, those memories need to be neutralised first.

If the client’s responses are the result of ongoing traumatic experiences, for example regularly being beaten up by a drunken spouse, etc. they need a different more immediate form of help than you might be able to offer.

The Process

Ask the client to think of the other person, if their response is strong, then you may need to take the extra safety measures described below.

SAFETY MEASURES

If imagining the problem person causes a strong emotional response in your client, you can make it safer for them by letting them know that they are in charge of the process, and you will not proceed to the next step until they feel safe to do so.

When we are in the presence of danger, most of us will feel safer if that danger is far away from us rather than close at hand.

Ask the client “What would be a safe distance for that person to be?” this could be metres, kilometres, hundreds of kilometres away.

Invite them to: “Put that ‘other person’ at a safe distance from you, however far away that is”.

Ask them: “What is going on in you as you imagine them at a safe distance?”

Process their reactions, for example the fear, dread, disgust or whatever it is that they are experiencing. Process all those reactions before proceeding.

Ask the client: “What is a safe distance now?”, then invite them to put that person at the new ‘safe distance’.

Ask them: “What is going on in you when they are at this safe distance?”, then process those responses.

Repeat this process until they are just outside the room the client is in (you can have them close the door, or imagine a closed door).

Ask them: “What happens if you imagine opening that door to let that person in?”

Process those reactions (you may need to reassure the client that they are not going to ’let problematic person in’ until they feel safe).

When they feel safe, they can ’let that other person in’.

General instructions

Ask the client to put that imagined ‘other person’ at a safe distance (more than one arm’s length away) and ask them to pay attention to their internal experience.

For example:

they (the problem person) looks angry, sad, frustrated
I don’t know what to do
I feel trapped
etc
etc

Use the tapping process to soothe whatever is going on in them.

Ask them, “What happens as you look at this person now?”

Keep processing whatever comes up about the problem person, or themselves, until the client can be calm in their imagined presence.

Testing for the future

If your client is going to see the problematic person again, there are extra steps you can take to help your client be at their best when they do.

Ask your client when they will next be seeing this person, have them imagine that situation and notice what happens.

As they go through this mental rehearsal, process any emotional blips that arise.

When they can imagine meeting this person in a calmer, more resourceful way then you are done.

Remember, as a practitioner, you are also human. If you have some ‘heartsink’ clients, you might find this process helpful for yourself.

References

O’Dowd TC. Five years of heartsink patients in general practice. BMJ. 1988;297(6647):528–530. doi: 10.1136/bmj.297.6647.528.

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