Therapeutic relationship. What do you need to know ?

«The therapeutic relationship serves as an internal reference,to which patients can return to by using their imagination»
C. Rogers

Therapeutic relationship. What do you need to know?

Many have praised the transformative dimension of this relationship which ranks at the top of the therapeutic pyramid. The "life work," as Yalom underlines, which is carried out in collaboration by the therapist and client, is to build a relationship that will become its own agent of change. Elsewhere Yalom says: "... therapy should not proceed based on the theory, but on the relationship"

The therapeutic relationship provides a safe context in which the patient will be able to investigate and experiment, not only the way to have a more meaningful relationship with himself and with others but it might also function as a «rehearsal of life».

What is the role of the psychotherapist?

«A Friend is the man who nurtures the best and healthiest elements of the other person»
The multifaceted role of the therapist becomes evident from the aspects attributed to him; these are sometimes referred to as the co-traveler, mentor, philosopher, keeper of secrets, nurse, researcher, parent, teacher, priest and sometimes to transcend his gender acting as "midwife" or made to put on the terrifying role of love’s executioner.

All these characteristics correspond to qualities that are important for the therapist to cultivate in order to safely lead the client to the anteroom of change. Depending on the approach embraced by the therapist certain roles will become more dominant.

a) TheTrainer/Therapist:
In Transactional Analysis for example the trainer is the one who is more overt, since the client is encouraged to learn the concepts of transactional analysis to facilitate communication. Similarly, «the mission of the speech therapist is to educate patients to take responsibility for their lives» (Loukas as stated in Cooper).

b) The Priest/Healer:
In transpersonal theory, «thought is part of the problem ... We need something beyond this dualistic approach. We need a third possibility, and this is the soul» (Moore). The patient then learns to harmonise with his inner sainthood which originally was the work of the priest.

c) The Philosopher/Therapist:
Existentialism , at its core brings the philosopher-therapist to the forefront since «existential therapy is more a philosophy than a psychotherapeutic system» (Prochaska & Norcross).

d) The Friend-Ally/Healer:
Apart from the different dimensions and levels of consciousness upon which the therapist has to work, there are some fundamental features that meet in a key role, that of the friend. According to Aristotle’s definition "friend is the man who nurtures the best and healthiest qualities of the other person". In fact, the therapist allies himself with the healthy elements of the client in order to begin the transformation of the patient’s destructive side into constructive activities achieving a higher level of integrated consciousness.

In short, the basic qualities needed by the therapist in order to create a safe environment to welcome the client in are: respect, empathy, authenticity, knowledge, flexibility and humility. Once we create a fertile soil, we can accommodate the client and along with the client one of the most important therapeutic factors: the therapeutic relationship.

«The authenticity of a person is defined not only by his willingness to know himself but also by his willingness to become known by others»
J. F. T. Bugental

What is the role of the client?

The therapist alone does not have the ability to change the inner reality of the patient. The role of the latter lies in the willingness to actively cooperate with the therapist by participating in the establishment of the therapeutic alliance (a simple/practical example of cooperation is that of being punctual for sessions).

When one starts the process of soul searching, the client will inevitably experience the anxiety ofauthenticity and will try to resist by obstructing the development of his inner awareness. According to existential/humanitarian therapists this may be done in the following ways (M. Cooper):

  1. Change of subject
  2. Distractibility
  3. Talk about platitudes
  4. Use formulaic expressions in a polite, formal, abstract or uncaring way
  5. Talk so fast that the patient cannot "hear" himself
  6. Rationalize, analyze.
  7. Distance himself from the experience and start talking to himself as if he was another person

The therapist needs to help him understand how he remains resistant while at the same time remaining open to the fact that «the essential nature of Dasein requires us to be as open to non-authenticity as to authenticity*» (van Deurzen)

* Authenticity refers to the capacity and the intention of the person to be truly open and honest in the exploration of both himself and in the interaction with the other.

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