Lately, many of my clients have been struggling with emotions that feel uncontainable. At times, they describe an internal void so physically painful to sit with that it feels like a vacuum demanding to be filled. This sense of emptiness and disconnection—the feeling of not knowing if you are truly “real” to yourself or others—can make the simple act of “going on” feel impossible.

If this resonates with you, you may feel that your internal world can only be made real to others if you act it out, physically manifesting your pain rather than simply speaking it.

In therapy, I watch my clients make a slow, often painful progression:

• Moving from the belief that only actions can manage or communicate their feelings, to the realization that words are enough.

• Understanding that language exchanged between two people creates a shared experience that is meaningful and soothing, rather than empty or flat.

Along this journey, there is often a “middle ground” between action and speech. Clients may use emotionally evocative language as a bridge to ensure they impact the listener. For instance, a client might say they want to die, even if they aren’t suicidal. In this context, invoking death is an attempt to convey the magnitude of their pain in a way that goes beyond mere description.

With time, the presence of the therapist and the rhythm of the sessions create a symbolic womb—a space where new experiences are born and words become animated.

While words help us share our lives, they also define our boundaries; they highlight the separateness of two distinct minds. Paradoxically, it is this very separateness that makes communication necessary. As clients begin to feel that their words truly reach and impact the therapist, the need for dramatic action or “shocking” language decreases. Eventually, an ordinary back-and-forth becomes sufficient to fill the void with the relational nourishment they’ve been seeking.