What does my therapist mean to “sit with it?”

| Bryan Landaas LCSW

We therapists have the tendency to use a bunch of psychobabble and it may not always be clear what we’re talking about when we use certain terms. Describing emotional and psychological experiences is often abstract and can be difficult to put into words. I’d like to take a stab at clarifying some of the common words, terms, and phrases mental health professionals frequently use in order to make them easier to understand. Whether you are an experienced therapist or a person who has never participated in therapy, I think we can all benefit from clarity in our communication.

What does it mean to “sit with” something?

When we ask somebody to “sit with” some aspect of their experience such as an emotion, a thought, or physical sensation what we are encouraging our client to do is simply to observe, or notice, what is going on in their window of consciousness while attempting to not react to it. Essentially, we are literally asking our client to just sit there and observe…..no thinking (but all thoughts are welcome), no action, just sitting there being still both physically and mentally.

This is a core aspect of what is often referred to as mindfulness practice. Mindfulness involves intentionally focusing your attention on one or more aspects of your present-moment experience with a sense of curiosity. Being curious means taking a persistent interest in what it is you are observing. Think of what it feels like when you finally get to the scene of a traffic accident after sitting in stalled traffic for 30 minutes. You may not want to look or feel good about looking, yet what we often experience is a powerful urge to survey the scene and notice what’s going on…..if for no other reason than to placate that urge. This kind of curiosity isn’t necessarily pleasant or lighthearted in nature (traffic accidents are certainly neither), but rather a compelling sense of needing to notice what is going on. When you practice mindfulness you want to cultivate this deep sense of curiosity towards your thoughts and physical sensations, even the ones that may seem like a wreck.

Here’s how this works in the treatment of anxiety, depression, and really any other mental or emotional distress. Both anxiety and depression consist of emotional, psychological, and physiological components and all of these components interact to produce a state we label as “anxiety” and “depression.” When applying “sitting with” mindfulness practice we are encouraging a process referred to as defusion or decentering. Adopting a stance of open awareness and curiosity allows you to notice each aspect of your experience as individual, separate components rather than simply “anxiety” or “depression.” This in turn will allow you to more effectively process (more psychobabble) and respond, rather than react, to uncomfortable emotions, thoughts, and sensations. 

Exactly how this works is still somewhat of a mystery, but research is beginning to help us better understand the impact mindfulness practice has on our brains both in the short-term (state) and long-term (trait).  In a nutshell, it seems that when we adopt a mindset characterized by observing, focusing, and paying attention we activate certain neural networks in our brain that just so happen to also deactivate other networks of the brain (i.e., the ones associated with emotional and physical discomfort and pain). When we are observing our experience by “sitting with it” we are actually dialing down the brain’s fight-or-flight networks as well as our thinking networks. This allows us to more fully connect with our present-moment experience which in turn provides the opportunity to release “here-and-now” neurotransmitters that are responsible for producing pleasant feelings.

Pair this “sitting with” practice with a simple structured breathing exercise and before long you’ll be one mean stress-busting machine.

Today's the day to make a change.