What is Relational Therapy?

17 Nov What is Relational Therapy?

November 17, 2011

What is relationality and how does it play out in psychotherapy these days? Are all therapies relational? Or at least all non-medical model therapies? What challenges do relational therapists confront?

A communication from a therapist in Norway sparked these questions for me. I have the privilege of lurking in an online course the East Side Institute is currently running—“Helping Clients Discover the Other: A Clinician’s Guide to Social Therapy.” (The course is taught by my dear friend and colleague Christine la Cerva, a gifted and very creative therapist, director of the Social Therapy Group and the Institute’s clinical training programs; you can check out her newsletter, The Community Therapist.) In response to Christine’s first post and invitation to the 20 participants to introduce themselves and share how a deeply-held assumption was challenged in their lives, Paul writes of his history of professional training, his attraction to relational approaches as doing away with the imposition of the therapist’s authority, and the challenge  that social therapy’s radical relationality presents to his practice. I think Paul’s story (excerpts below, with his permission) not only encapsulates a journey he and many others are making, but also begins an exploration of a critically important ethical and methodological issue that psychotherapy needs to confront.

I live in Oslo, Norway. I work as a psychologist and for two years I lived in NYC and trained with the East Side Institute. ?At the time I moved to NYC in 2004, I was only a few years out of school, and heavily influenced by the diverse therapies coming out of family therapy that had developed from the 60s to the 90s from an interest in cybernetics, epistemology and into social constructionism and postmodernism. My orientation towards these therapies had much to do with a strong reaction against what I then understood to be a psychodynamic/analytic orientation to therapy and how it was built to position the therapist as an impenetrable Knower to manage the patient as a confused knot of uncontrollable and multiplying transference symptoms. Colonizing, imposing and thus hurtful to its patients.

I realize that there are friendlier and probably helpful versions of this, especially for the competent and affluent. But throughout many years of the student work I did in different institutions and clinics, the ruling and psychodynamic view of patients and their symptoms was almost always paired with a modernist interpretive stance toward patients’ lives and symptoms, often made by therapists who did not themselves see the patients, and who presented their judgements as truth. These very, very small versions of these persons (patients) became their totality, and had very real and shocking effects on the treatment, developments, lives and deaths of these people.

So I fell in love with the progressive therapies that seemed to develop responses and alternatives to that psychology, through slogans such as “the client as the expert” and methodological orientations such as “the not knowing stance.”

I think I became allergic to imposition. And in my assumptions, I thought I knew a lot about the million ways of imposing on other people’s lives, and the way to counteract them. One of my versions was to become a therapist of lightness, to aim to leave no trace, and the method would ideally be: ”a tap on the client’s shoulder… for the client to re-orient (in what I did not need to know nor impose on) and know how to go on.”

I was perhaps a friendly ghost.

Then I came to the East Side Institute and met social therapy and radical relationality.?And my assumption that not imposing, colonizing, or hurting other people in therapy was the invention, preparation and solo work of the therapist was strongly challenged!

I was told that this was impossible. That I could not by myself decide that authority was no longer an issue. I could not throw all the cultural commodities of possible imposition out of the therapy room before the client enters. We would have to build something together, from what we had to build with, that might or might not transform or challenge the imposition at hand. We might not even have what we would need to begin that work.