Increasing Attunement in Psychotherapy: Building Deeper Connections for Healing

What is attunement and why is it important?

  • Attunement is about being fully present and responsive. Being emotionally and psychologically all there.

  • We can’t discuss attunement without giving credit to Dan Siegel, Heinz Kohut, or Mary Ainsworth. They’ve paved the way for us to better understand why this is an essential skill in psychotherapy.

  • Let’s work backward:

    • You know when someone isn’t attuned to you. You’re having a one-way conversation and they’re looking at their phone and being barely responsive. A nonversation, if you will. Of course, this is a drastic example and hopefully none of the therapists reading this are looking at their phone while in session.

    • On the flip side, you’ve hopefully had the experience of being fully heard with the other person responding verbally and non-verbally. Both feel wildly different.

What Is attunement in psychotherapy?

  • In psychotherapy, attunement isn’t only a skill, but a core element of effective psychotherapy

  • It fosters trust, psychological safety, and emotional healing in the therapeutic space

  • Attunement isn’t a one time thing - it’s an ongoing, dynamic process of aligning with the client’s emotional experience

  • Signs of strong therapist-client attunement:

    • clients feel seen, heard, and understood

    • emotional alignment promoting deeper exploration of issues

    • clients are able to name when something feels off - you’ve misunderstood them, etc

Barriers to attunement in psychotherapy

What gets in the way of being attuned?

  • Therapist burnout - healthcare providers who worked during peak COVID, I see you. I am you. I worked past my limit to support my patients and had months where I barely kept my head above water. I fantasized about doing anything else. Being a nail tech sounded luxurious.

  • Therapist distraction - life happens.

    • We all know this. My personal belief is that if you are a practicing clinician, you need to be in therapy yourself to work on your own shit. If you’re really distracted, take a day off. Take a week off.

  • Client reluctance - totally fair. Some client just don’t want to be there.

    • Connect with them in a way that:

      • a) feels good

      • b) helps them feel like they’ve accomplished something that session

  • Emotional dysregulation - we’ve all had off days, but I’m talking about extreme emotional dysregulation here.

    • Are basic needs being met?

    • Maybe we need to get back to basics before doing any deeper work.

Example of misattunement:

  • Misinterpreting emotions - ask instead of assuming

  • Rushing the therapeutic process - building trust and developing the therapeutic relationship takes time.

  • Being overly directive instead of emotionally dancing with the client.

Steps to increase attunement in psychotherapy

  • Cultivate presence in yourself

    • Practice mindfulness or grounding exercises, minimize distractions

  • With the client

    • Consider starting with a brief check-in to tune into the client’s emotional state

  • Focus on non-verbal communication

    • Maintain open and welcoming body language, match your tone and pace to the client’s, notice subtle cues like a foot tapping, hands wringing, changes in posture and energy

  • Reflect and validate

    • Paraphrase and reflect the client’s emotions without judgment (again, how do you need to take care of yourself before the session so you can fully show up?)

    • Use statements like, “It sounds like you’re feeling…” or “I can see how that would be difficult.” Statements to validate the client’s experience and show them that you really hear them.

    • Acknowledge and possibly name both verbal and non-verbal expressions of emotion

  • Stay curious and flexible

    • Ask open-ended questions that encourage deeper exploration

    • Adjust your approach based on the client’s needs in the moment

    • Stay open to shifts in the session’s direction as emotions unfold

  • Engage in self-attunement

    • Check in with your emotional state during sessions to make sure you’re grounded

    • Address your own biases or reactions through supervision or self-reflection

    • Regularly practice self-care to maintain energy and focus.

  • Foster a collaborative relationship

    • Invite the client to share feedback about the therapeutic process or how the session felt that day

    • Discuss their goals early in therapy and throughout the therapy

    • Trust that the client is the expert on their experience

Conclusion

  • Therapists: think about two ways that you can strengthen your attunement with clients

    • Tips:

      • Walking side by side from the waiting room to your office

      • Validating their emotions

      • Maintaining open posture and body language

      • Practicing active listening

      • Creating emotional and psychological safety from the beginning

      • Trusting that the client is the expert on their life and experience

      • Attunement is a shared journey of connection and growth.

Attunement is a dance: a shared journey of connection and growth