CSAR

How We Know We Are Known

by Janina Fisher

Attunement is a word routinely used by psychotherapists and often parents as well. But as we talk about ‘attuning,’ we rarely ask: “What is ‘attunement'”?  How can we human beings ‘tell’ intuitively that we are being ‘met’ or ‘gotten’ by others?

Although we use words to convey our ‘getting it’ or our willingness to ‘meet’ or ‘recognize’ others, attunement is a somatic experience. We feel attunement in our bodies. We “know” we’re being understood without always being able to put into words how we know we are ‘known.’

The somatic experience of attunement is at the heart of infant-parent attachment. What we call ‘attunement’ is that moment when the baby’s distress settles, cries are replaced by coos, the child’s body relaxes and, in tandem, our bodies relax, too. As the baby melts into our arms, and our bodies melt into theirs, there is a warmth that pervades each and a sense of closeness beyond words. I call this moment ‘attachment bliss’ or ‘attachment euphoria.’ The feelings of closeness and well-being are deeply pleasurable and almost hypnotic. We call it ‘attachment bonding’ or attunement or even love, but those words cannot convey the profoundly pleasurable physical experience of those moments. And the mutual relaxation and sense of shared warmth not only regulates the immature infant nervous system but also regulates parents and ‘fuels’ them for the next challenge or the next distress—which may be only minutes away.

The capacity to be ‘attuned’ is also connected to the body. To sense others’ needs, emotions, moods, we have to be able to pick up their ‘signals,’ presumably via our mirror neurons. We quite literally resonate as our mirror neurons fire in tandem with the other’s. But this reading of another individual’s signals will not feel ‘attuned’ unless we can communicate it back in some way that meets or regulates their needs and emotions. My experience tells me that we communicate our attunement most clearly when we are able to ‘co-regulate.’ That is, when we can feel our bodies and emotions responding to the communications of our patients, partners, children, and friends, and when our reciprocal implicit communication not only conveys resonance but also in some way meets the nonverbally communicated needs of the other.

The most familiar example occurs daily for most of us. A patient, friend, or loved one expresses an emotion, and we want to convey our attunement or to offer comfort or support. These are the moments when, despite our best efforts, empathic mis-attunements often occur—but they are also the moments when we have the opportunity to communicate that we do ‘get it.’ When mis-attunements occur it is often the result of a mis-match, I believe. The patient longs to feel ‘understood’ because attunement feels so pleasurable and may have been so elusive. But even the most ‘attuned’ words with which we try to convey our understanding of what we sense somatically do not always communicate resonance. When instead we ‘co-regulate’ as a way of expressing attunement, we are not relying on language.

Co-regulation involves changes in gaze, tone of voice, body language, facial expression, warmth and earthiness, lightness or heaviness, affect, or muscular tension in response to our body’s reaction to the patient’s previous communication. A friend tears up while describing the recent loss of his beloved dog, and I sense in my body his discomfort with the tears and how he tenses against them. Conventional wisdom about attunement would suggest that I need to deepen my voice, increase my vibrato, and convey sadness—to ‘meet’ his grief rather than resonating to his fear of it. But my attunement to him asks something different of me. Sensing his dread of the grief, I respond by co-regulating: I smile, remembering the two of them together, and there is a cheerfulness and a smile in my tone of voice as I say, “Yes, big man/small dog/ great love—never to be forgotten.” His bowed head looks up, meets my gaze; he takes a breath, and I can see the emotions settling a little bit. Uncharacteristically, this big man who never cries begins to tell me about the strange encounters he’s been having with his emotions as he grieves the loss of his little companion. Knowing that this is a delicate moment, sensing how easily he could be scared away from what he’s feeling, I keep adjusting my tone and affect so that his emotions are regulated by my contact. I can feel in my body the holding of both of us just at the edge of the intense sorrow he feels, so that he is in touch with it but not overwhelmed. My words reassure him that his reactions and emotions are normal, but my co-regulating supports his feeling able to bear them.

Just as parents instinctively co-regulate infants to make them more comfortable, co-regulating our adult patients and loved ones so that they feel less threatened by their feelings and impulses paradoxically allows them to have more range; to tolerate feeling more rather than less. By co-regulating in response to my friend’s loss, he is able to stay in emotional contact with me and to sense implicitly the ‘attunement’ in how my body communicates support for his loss, his emotions, and his fear of those emotions.


Janina Fisher, Ph.D. is a licensed clinical psychologist in private practice, the Assistant Director of the Sensorimotor Psychotherapy Institute, an Instructor at the Trauma Center, a research and treatment center founded by Bessel van der Kolk, an EMDRIA Approved Consultant and Credit Provider, former president of the New England Society for the Treatment of Trauma and Dissociation, and a former instructor, Harvard Medical School. An international writer and lecturer on the treatment of trauma, she is co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma (Norton) and author of the new book Healing the Fragmented Selves of Trauma Survivors (Routledge).

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