In my previous post, I suggested that a function of the sensation of the passage of time is part of our pattern recognition abilities. The sensation of time provides a background standard to organize the contents of our lives. We categorize, prioritize, plan, and respond based on the sensed temporal immediacy.

In our work, ‘sensed’ or ‘felt’ time has great relevance. The anxious, overwhelmed client not only experiences a swarm of threats; all of those threats are bearing down on him NOW. For the anxious there is no reprieve of ‘later’. As one of my clients described it, ‘I’ve gotta do everything right the hell now!!’

Similarly, the depressed client, especially when in a dysphoric mood state, is immobilized by regrets anchored in the temporal space of NOW. While clients may describe events in the past tense, their affect and cognition are temporally centered in the present and in the future. A client described his misery as watching ‘reruns of past failures scheduled for the next hundred years’.

In order to feel better our clients must do things that give them pleasure and mastery. Because of its enormous influence on their abilities to plan and do things, our clients’ temporal orientation is vitally important. The good news is that temporal reorientation in the vast majority of circumstances is accomplished easily. Here’s some of the ways which I’ve noticed and which I’ve developed further:

1. The imposition of temporal order through activity scheduling. The mere establishing of appointments has a reorienting effect. Cognitive therapists have long used activity scheduling to extend our efforts to bring the client back to the unpolluted now.

2. Helping the client establish a renewed sense of time through dialogue. The client centered psychotherapies in general, and cognitive therapy in particular, have always advocated ushering the client into the moment. We do this with dysfunctional thought records and with all of the homework assignments that we prescribe.

Most importantly it is our reassuring insistence which compels both client and therapist into the present. Instead of preoccupation in the past, we focus on present symptoms and ways to feel better now. While I acknowledge that past experiences and future risks are part of our work, I often explain to my clients that the best way to heal their lives and help them blossom, is to be rooted in the loving embrace of the present moment. From that secure position they can go back or forward in time and process anew the traumas of the past and fears of the future. 

To be continued!