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Therapy Demystified: It’s All in the Relationship
In the presence of darkness, we break, we wound, and we crumble inside; in the presence of kindness, openness, and love we heal with one another.
When asked what my “style” of therapy is, I spout an eclectic mixture of therapies like “psychodynamic, supportive, and relational psychotherapy,” but I truly believe that the most important element that can lead to healing in a therapeutic relationship is the connection between the therapist and client. This is not a typical connection, because it is not reciprocal; it is only intended to serve the client’s interest. But it can be even more powerful in healing broken hearts and wounded souls because of the commitment of the therapist to the client.
Many esteemed researchers have come to the same conclusion through different avenues. Scholars like John Bowlby, Alan Schore, Daniel Siegel, and Robert Karen would liken this connection in therapy to healing wounds from lost or ruptured attachments in childhood and adulthood. There is neurological research proving that being in connection with another person can actually create new neurocircuitry, or pathways, in the brain in order to form new attachments to others (Schore, 2003). The authors of Relational-Cultural theory discuss connection as a “growth fostering relationship” leading to a fuller, happier life, as opposed to disconnection as “empathic failures” and missed opportunities (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Jordan, 1997; Miller & Stiver, 1997). The arrival at this conclusion, that people heal in relationship with one another, is empirically undeniable.
But what does this look like in the therapy room? Many will experience it as discomfort at first because it feels unusual to have someone in front of you who needs nothing from you and is there to openly explore your psyche. I hope to alleviate some of that discomfort for those of you who are reading because therapists are humans too and we are both engaged in the process of relationship building the moment you walk in the door.
The experience “in the chair” can be enlightening for some in that it brings up feelings that are universal throughout the person’s life. For example, a person comes to therapy with severe social anxiety. He tells the therapist this piece of information and the therapist responds by saying, “what a brave move you have made coming here since you are so scared to leave the house.” The client may feel discomfort, vulnerability, and like he is being seen and heard, feelings he is uncomfortable with in the outside world and in the therapy room. The question is, what do you do with those feelings? Is the therapy room safe enough to explore those feelings of discomfort?
It is the therapist’s job to make sure there is as much safety as possible for the client. In order for there to be safety, the client must understand that the therapist will be non-judgmental and genuinely caring. She must also know that the things she says are confidential and will be kept safe with the therapist. The client must also know that the therapist is taking care of herself and will continue to do so throughout the relationship. For example, the client must know that his therapist will show up on time, will hold to their agreements, will have taken care of her own needs so that she is present, follows her code of ethics in order to maintain a practice, and is working in the best interest of the client.
This is not to suggest that the skills therapists learn from other empirical research is useless. There is skill involved in exploration and presence while witnessing such important work. However, we heal through one another and it should be known that if you are experiencing emotions like discomfort, tension, frustration, resentment, happiness, or any other feeling, especially toward the therapist, they should be welcomed in the therapy room. They are incredibly helpful keys to unlocking closed doors in our minds and discovering how we behave in the outside world. They can also lead to healing old wounds and finding new ways to open one’s heart to others.
a blog about therapy 
This is outstanding, Elena. By the way, are you up for the Versatile Blogger Award? You deserve it. See my post tomorrow at 5:00 a.m. Happy New Year!
Jim Amos, MD
The Practical Psychosomaticist
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I could not agree more about the relationship being so key in therapeutic work and healing. I have had the privilege to work with some excellent therapists and lay counselors. It was the safe relationships that helped me the most. They gave me the strength and information needed so that I could do a lot of my healing work alone…just G-d and me.
On the flip side, I also interacted with some therapists who were real nightmares. The nature of the relationships was NOT one of safety. Two were arrogant…it was about them and hurting others was OK to get what they wanted. Another one accessed my programming and used me.
Relationships and the focus of the therapist on the client. You have to have both!
I believe that the relationship between the therapist and client is the most important part of effective therapy! Wonderful post. 🙂
Than you for you insights. I believe this information is important for those who are seeking help, or new to the experience. It is reassuring for people to have at least a general idea of what to expect. As a man, it’s my belief that if other men can ease their way into it, because of the element of the possibility of dealing with emotions, they would benefit greatly.
I have nothing to add, except I have had mostly that kinds of interactions you mention. I did have one counselor who’s introductory statement to me, after my ADHD 5minute, 100mph, blurp, was “you don’t listen to well do you?” I can microns from getting up and leaving, but instead said “thank you”. She immediately said “that’s odd, why would you say thank you?” My reply was I wanted to be respectful instead of getting up and telling you to go to hell on my way out”.
We got along reasonably well after that, but this is where the finer points of your thoughts come out with support and understanding. I survived it, and no worse for the wear.
Finally, it is my strong belief that people must take on 98% of the responsibility for their “recovery”, not the therapist, because there is so much to know about the brain, along with thoughts and emotions it’s incredible!
Nice post. I went through the post I found it very informative and useful. Thanks for sharing.
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This is a great post, thank you for sharing it.
“The Counselling relationship is not an equal one – As the most important person in the Counselling relationship is the client, not the Counsellor”