Category Archives: Theory

Notes on the Psychotherapeutic Relationship: 1

The whole of the psychotherapeutic enterprise rests on the psychotherapeutic relationship. It strikes me that attempts to describe or define it have to overcome the difficulty that this mostly subconscious process takes place in private settings. Who is in a position to observe it? For this reason I intend to investigate it largely on the basis of my own personal experience, and using clues and pointers from others that ring true to me.

My first observation is that the psychotherapeutic relationship belongs to the class of human relationships that we call conversation, using this to include both verbal and non-verbal transactions. Here we can make use of the valuable observations of Theodore Zeldin. From Zeldin I draw a clear distinction between genuine and false conversation. In the genuine conversation each party enters in a generous spirit, prepared to emerge from the process having learned from it, having been altered. The fences are down; one is willingly risking that one may be wrong or mistaken, and may have one’s views transformed.

Conversation loses its genuine function when a power play is operating. This neurotic pseudo conversation is exemplified to comic effect in the one-upmanship books of the humorist Stephen Potter.

When the sufferer, client, analysand, patient, comes to psychotherapy, he is thirsty for genuine conversation but expecting to be thwarted, as his experience and his world view instructs him.

The psychotherapeutic relationship is a conversation in which power play is negated and a generous engagement in the sufferer’s interest on the part of the psychotherapist is felt by the sufferer. For this to be possible it is obvious that two conditions must be met: Firstly, the psychotherapist has to be capable of setting aside or overcoming any need on his part of showing or feeling superiority. Secondly, the psychotherapist has to demonstrate that the sufferer’s interests are paramount. Both these conditions must be met and be genuinely felt.

By negating the struggle for power the psychotherapist models a way of conversing, which opens up a dispassionate search for truth.

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Integration in Psychotherapy

Over the past century there has been a great proliferation of approaches to psychotherapy. Each school elaborates its own theory and practice, its own concepts and assumptions, and in its own language. The terrain of psychotherapy is a patchwork of fields separated by impenetrable hedges. Each school of thought is in competition with the others but at the same time acting as if the others were not there. Each is unintelligible to the others without a dedicated effort of translation and understanding. It is very unlikely then that real advances in the art and science of psychotherapy can spread beyond the schools where they are made.

In any other field we might expect to see competing theories and practices, it is true, but we would also feel that unity was being approached stepwise as the whole field moved conscientiously and cooperatively in the direction of truth.

I do not count the effort at integration, where psychotherapy and counselling courses lump together a few of the separate traditions, perhaps hoping that the students themselves will synthesise something useful. The Integrative students I have met for the most part think that they have been given a bundle of distinct tools, that they can select from. There is no integration here.

And indeed given the sheer number of distinct traditions, it would take millennia of each talking and listening to each before common platforms could emerge.

There is a better way. By rising above the field onto a philosophical plane we could establish the parameters of a genuine advance in psychotherapy. Fundamental to this undertaking is the need to establish a clear view of human nature in its connection with the world. It would need to be able to distinguish from each other both the apithology and pathology of the soul. This is what this series of postings hopes to contribute to.

It could be objected that theory is not as important as the practice of psychotherapy. And it is quite likely that experienced and wiser psychotherapists will resemble each other over time and learn to see beyond the limitations of theory. But theory whispers so seductively and so insistently into our ears as we practice. And if the theory misleads us, is not our practice in jeopardy?

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