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Helping Clients Free Themselves From Meaning Making and Emotional Pain
By Karen R. Koenig, LCSW, MEd

In order to talk about meaning making, I must introduce you to my cat who occasionally races around the house and slams her not-so-sleek self into a cabinet or table leg, then immediately slows down to a more reasonable clip. She exhibits a similar lightbulb moment when she spots the nylon cat carrier that ferries her to the vet for her annual shots—one visit and she’s carrier-averse.

However, my cat also knows a thing or two about how to avoid driving herself crazy. After smashing into a cabinet, she doesn’t berate herself all day for being foolhardy or clumsy. She doesn’t think she’s stupid or a feline failure because she gave herself a whack on the noodle. Nor, when she eyes her carrier, does she believe she’s a victim and whip up a drama about the unfairness of being poked with needles by a white-coated stranger. In short, she neither makes meaning of painful events nor continues to think about them at all.

Why can’t our clients do the same? Why must they carry around the pain of terrible and terrifying experiences 24/7? Why do they hurt so badly so long after the fact that it seems as if their psyches will never mend? A piece of the answer is in the meaning they make of traumatic events that have befallen them. As painful as trauma can be at the time, what gnaws away at clients like a flesh-eating virus is their unconsciously made, ongoing interpretation of what happened to them.

The reason we make meaning of events and my cat and other animals don’t is our enhanced brain function—higher order thinking that puts a spin on events for us to better recall them. Although humans incline towards meaning making, it’s important to recognize that just because we’re programmed to act in a certain way doesn’t mean it’s beneficial to us in the long run. Meaning making is not conducive to optimal functioning when an interpretation plagues clients, makes them fearful, and jeopardizes the quality of their lives.

As a cognitive-behavioral therapist for 30-plus years, I’ve encouraged clients to reframe beliefs, urged them to question others’ motivations when they feel hurt, and reminded them that what someone says about them, even if it has their name attached to it, is still all about the speaker.

For example, a client recently lamented, “My ex-husband lives nearby with his new wife and he hates me.” When I asked how she knew this, she sighed as if the answer were obvious and said, “Because he never even looks at me when we run into each other, like in the supermarket the other day.” She had no idea that the meaning she’d ascribed to her ex ignoring her had been made unconsciously, and was intrigued when I suggested that he might be indifferent to her, have been caught off guard, or have felt embarrassed by the awkwardness between them.

Who knows whether one of my meanings or hers is correct. More to the point, why affix any meaning to the event when my client might be better off simply noting that there’s a disconnect when she runs into her ex and leaving it at that? Then she can anticipate his eye aversion, yet forgo creating a negative emotional experience out of it. If she insists on reading meaning into her ex’s behavior, at the least, I can help her consciously generate more plausible explanations.

As we know, most of our interpretations of what occurs in life and in the lives of our clients come about unconsciously, especially under circumstances that trigger intense fear, helplessness, or horror or are physically or emotionally threatening. It makes sense that we would automatically give extra weight to anything that causes deep pain by attaching meaning to it to avoid a similar threat in the future. The assumption here is that if we can understand why an event has occurred, we should be able to prevent it from occurring again. But is this so? It certainly isn’t how my cat functions; she doesn’t need to make meaning of bumping her head on our patio slider to remember not to do it again.

The meaning we assign to painful events that occur in childhood are particularly susceptible to being erroneous and detrimental to later functioning. Our brains are not fully developed until some time in our late 20s, so as children, we’re trying to make sense of the world without the benefit of mature frontal lobes, which are the seat of critical thinking. No wonder we’re prone to misinterpretation: Mom hits me because I was bad, not because she can’t control her anger; Dad drinks because I upset him, not because he’s addicted to alcohol; I was raped as a teenager because I walked home from the party alone in the dark, not because I happened to come along when some man with poor impulse control acted on his need for dominance.

Sadly, the earlier painful events occur, the longer we live with them and internalize the meaning we’ve made of them as fact. At some point, the two become fused together, the event—the who/what/where/when—of the experience and the why or meaning of it. When a client says, “I still hurt because of how my mother used to scream at me when I didn’t make the bed right,” what she’s really saying is that her memory of the event is bothering her. It couldn’t be the actual bed-making interaction that’s causing the pain because that happened to her decades ago. Instead, it’s her recollection of the pain she experienced long ago and the meaning she has made of it that is troubling her: that her mother didn’t love her, that she was a bad child and couldn’t do anything right (including something as simple as making a bed), and that she deserved to be yelled at.

Take away the upsetting meaning of the experience or supply a more appropriate one, and the pain disappears. We could do this by saying, “You did nothing wrong. Your mother needed to let her anger out on someone and you just happened to be it at that moment. It was a perfectly random occurrence,” or “Your mother wanted you to grow up to be a good housekeeper and be able to take care of yourself properly, so she was trying her darndest to teach you well because she loved you and believed that was her job.” Both of these meanings act as pain anesthetizers because they put the event in a totally different light. With a new slant on the interaction, all the client is left with is the memory of a possibly poorly made bed, surely an emotionally neutral experience.

There’s also a vital distinction to be made between pain experienced during an event—say, a client being bitten by a dog—and pain which is recollected to the therapist as the client calls up his memory of the event. The client is not being bitten in the present, nor being hurt in any way. In fact, he’s sitting in a nonthreatening office with his therapist, so far removed from the actual event that he can think and talk about other things as well as his memory of the dog bite. Our job is to point out to clients that much of the time they are recalling pain they are perfectly safe and out of harm’s way and that there is no cause for distress. This observation helps separate the event from either an emotional reaction to it or a meaning being made of it.

We are charged with helping clients come to terms with the emotional pain they’ve experienced in their lives. Two techniques that have helped my clients reach this goal are exploring meaning making and understanding the difference between pain in reality and in recall.

— Karen R. Koenig, LCSW, MEd, is a psychotherapist and an expert on the psychology of eating.