Many people struggle to fully meet their therapist’s eyes the beginning. Particularly those who are shy or introverted.

The warmth, care, interest or love that we may perceive in a therapist’s compassionate gaze may seem “too much” or even unbearable for many who missed or never received it from their original caretakers.

Rachel was my first therapy client totally unable to tolerate the eye contact during a session. The first time we met, this lack of eye contact made me sense her anxiety; she looked like a captured bird, scared and ready to fly away at the first occasion. I thought she would not come back for another session, but she eventually did.

Rachel stuck to the regularity and timing of our sessions, but I kept having an uneasy impression that she was not entirely there. She had been in therapy previously for several years, and her previous therapists had seemed to accept her lack of eye contact without questioning it.

We were doing interesting work, she was open and honest, but my feeling of unease grew. So I decided to address it in the “here and now” with her.

What sense did she make of her avoidance of eye contact?

It helps me to not be really here. At the same time she readily admitted that she wanted to be in therapy and was coming willingly. But to be fully present was “too much.”

To avoid looking into other’s eyes is a very primitive and powerful defense mechanism. For human infants, it is not only a natural way of attracting attention and maintaining it, but also an efficient way of grading the intensity of contact. When we look away and avoid eye contact in a crowded subway train, we expect others to do the same and to not push in, staring at us. When somebody does not respect this tacit message, we may feel invaded, intruded upon in our private space.

Rachel had experienced sexual abuse in her childhood. When our freedom is restricted and we feel trapped (this is what any victim of sexual abuse goes through), the only way we are able to escape, at least partly, the abuser is to close our eyes or to look away. It then becomes the unique way of measuring the quantity of contact, a desperate hope to gain some control over an uncontrollable situation.

I felt compassion for the little girl that had been abused and silenced, but at the same time my frustration with her kept growing. I knew that somehow without confronting this problem our work would get stale.

Talking this through with Rachel helped us put the problem on the table. She was entirely conscious of the impact of her avoidance on our interaction, but still unable to take the risk and meet my eyes.

Look at me! I would I have screamed, had I not been aware of my countertransference.

But with the risk of repeating a traumatic experience, I needed to be patient and “to stay with it.” Her need for security and control was to be respected.

After a while, Rachel felt safe enough to share some painful details of her past. When her abuser, a family member, was with her in the room, she felt too terrified and ashamed to scream. Her parents “were not noticing” what was happening to their young daughter. Years later, when she could finally tell them what had happened, they still chose to ignore the uneasy truth and did not estrange the abuser from the family.

Rachel, a mature adult now, had to face her childhood nightmare, her abuser, at every family gathering. How did she do this?

She learnt to ignore him, to avoid looking at him. This strategy helped again to gain some form of control, an illusion of not entirely being there. Once again, this was the only thing in her power.

With time, I got used to her way of being only half-present, her need to securely preserve some parts of her self. I still enjoyed our dialogue, and the work we were doing around her artistic expression as a cello player.

After a year or so our work came to a natural end. Rachel was doing reasonably well, and she had played successfully at the audition she had initially been so anxious about. As result she landed her dream job in an important orchestra.

At out last session, before saying our goodbyes, Rachel’s eyes briefly met mine. I was now used to this fleeing, light contact between us and appreciated its meaning.

Thank you for not forcing me to make eye contact. When I was abused… he kept saying : “Look at me!” But I never did.

And she gazed at me steadily.

She seemed strong and composed: that looking away had preserved something precious in her; this is how she had defended herself and stood up to the abuser. The new Rachel was able to esteem herself, to fight, to win, and to be a passionate musician.

File under: The Art of Psychotherapy