The bases of relational psychotherapy
The Bases Of Relational Psychotherapy
Conjecture about a relationship and about relationships, the descriptions of the ecstasy and agony potentially involved, the warmth and security, the fear and suspicion often connected to relationships, has been at the heart of most of mankind’s cultural production over thousands of years. It provides much of the matter associated with the tissue of law which structures our societies and with the more abstract ideas of justice which underpin our laws’ general tendencies.
Psychotherapy, an exercise in relating, emerges from many different traditions with often contradictory histories and senses of direction. Healing is one such, as is growing up into a full member of society, as is a special awareness of the individual in his fraught connection with larger societal imperatives, as is the celebration of the care and love that cradles the child and protects the weak and indeed the opprobrium that results when these covenants are broken.
Psychotherapy is not distinctly and only in a limited way tied to pure observation and deduction, though learning from this Hippocratic model is obviously a part of the therapeutic matrix. It cannot credibly be defined in terms of results “based on evidence”, because the initial situations and subsequent developments are so varied as to be irreducible to any direct reading of cause and effect.
In the middle of all this sits the idea of relationship, in other words a value-weighted interaction whose dynamics activate, accompany and flesh out the processes we gather together under the term psychotherapy.
Humans beings are relationally biased. They seek the relational and generate little entirely outside this framework. The development of ideas and concepts emerges more from habits of dialogue and exchange than from the discrete thoughts and actions of any individual. The hinge of human experience is relational and psychotherapy sits (on occasions uneasily given the forces generated) at the hinge.
Because there is a searcher and a guide, even if he or she too is regularly in unknown territory, the relationship makes demands which cannot be straightforwardly symmetrical and which make specific calls on an ethical awareness of this particular separation of rights and obligations. These concepts, endlessly tortured, unfortunately, into ever more esoteric forms are actually rooted in relational common sense and a willingness to learn how to articulate standing back with stepping forward. Occasionally, but rarely, of course, a more formally regulated situational vision is required.
The many readings of the qualities of presence and of attention in different professions generally cluster around contractual issues, against, usually, a backdrop of humanistic or religious prescription mostly taken for wishful thinking. Psychotherapy, on the other hand, cannot afford double standards, precisely because the relational at the heart of our practice is attention and presence above all else.
The relationship in psychotherapy resists attempts at serial categorisation. Its unfoldings usually take anecdotal form or sometimes a complex subliminal existence rather than anything really apt for classification. Some potently invested fantasies moreover are what it most clearly is not. So, it is not a division of knowledge between one who knows and perceives correctly and one who doesn’t. It is a framework apt to produce individual knowledge and awareness rather than anything more normative. This is not to deny that some foundational awarenesses in life may be considerably more functional than others and on occasions may need to be taught. However an educational dynamic implies no particular imperative to find an inner resonance, the psychotherapeutic, yes. Because this process of noting and evaluating personal resonance is fraught with pitfalls and red herrings, the relationship over time, often astonishingly rapidly, takes on a meaningfulness first for the patient or client, but also for the therapist, which regularly seems to transcend stated needs and projects of response to them.
The relationship then becomes more than an adjunct to some process of change or healing, it becomes the vehicle. This puts the whole endeavour on a very different footing than those which are bound by various forms of action protocol elaborated by many practitioners over long periods of time, as in medecine. Put simply, density and qualitative richness, typical of the tissue of therapeutic exchange, are not elements which generally mark descriptions of release from symptomal suffering or the healing of pathological dysfunction. However these two fields of human difficulty and suffering have, in reality, been elevated quite recently to the only game in town, and this because of the pervasive hegemony of a self-referential, medecine-based vision of the essential dynamics of human existence. As a result, and because other dimensions of life are then functionally excluded from reflexion or exploration, psychotherapy has its wings clipped and is often reduced to apeing, from an impossibly inferior position, the dynamics and language of the medical model.
Icelanders, once upon a time, had their Allthing, a parliament to discuss whatever needed discussion and to debate and decide all the things a community found itself dealing with. Psychotherapy cannot and should not usurp societal dialogue and decision making. It is a Manything, however, not limited to what passes for a technical or scentific perspective on what constitutes suffering and the nature of normality (currently a shrinking continent). As such psychotherapy must continue to establish its own boundary marks, follow its own dense conceptual warp and weft. It cannot adopt or, worse, slip wearily or blindly into the structure of another, borrowed, paradigm, especially the current medical one, without denying what it stands for in scope, authenticity and pertinence and, I would add, that necessary catalyst of humanity, the ring of surprise.