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The Therapeutic Relationship

4/2/2015

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I believe that the relationship between a client and a therapist is sacred. It is not unlike what an individual would expect to experience when seeking wise counsel from a pastor, a priest, a rabbi, a shaman, or any spiritual teacher.  And yet, in my opinion, it involves so much more.  In addition to being a trusted confidante, one of the therapist’s roles is to create a safe and sacred space that allows the client to connect with and excavate difficult, threatening, and traumatic material in a way that does not overwhelm or further traumatize them. This takes incredible skill and intuitive abilities on the therapist’s part which, ideally, is being expressed with tremendous reverence and compassion for the process at hand. I believe that very little long-term, significant change can occur for the client if the therapist is not able to express from the heart.  And because of this, I believe that what makes this relationship the most sacred is that in order for it to be dynamic and effective,  it requires a great deal of intimacy.

 

Now I added an extra space between these two paragraphs to let my readers ponder a little longer on what it was I just said. I did this because I suspect that it will have set off some ethical alarm bells in a few folks.

“Surely, she didn’t mean intimacy?”

Yes. She did.

“Perhaps it’s a typo.”

Nope. It’s not.

I learned many years ago when studying with my indigenous, wisdom teachers that the highest frequency through which any of us can express while in this physical body and engaged with ourselves or another living being, is the heart. There is much research to support this claim. None of which, however, we’re going to discuss in this article. But suffice to say, it is my premise that very little healing can occur in the absence of a space or a relationship filled with heart. We’ll explore these ideas further in subsequent articles entitled: “Compassion Fatigue”, “What’s Love Got to do With it?”, and “The Dance of Relationship”.

Let’s start by identifying that intimacy does not infer the absence of boundaries. When studying to become a mental health counselor and when taking the examination in your respective state to become licensed, much of the material is devoted to learning what the ethical guidelines are that govern the therapeutic relationship. However, in order to become a truly effective ‘agent of change’; it is important to develop the ability to hang out very close to the edge of these guidelines without crossing over into forbidden territory. I credit my success in being able to do this with the fact that I am one of those therapists who is constantly working on themselves in an effort to bring as much awareness to the moment regarding how I might be getting in the way of the client’s process in order to ensure that I don’t.

The most important boundary to be maintained involves the understanding of what happens when the therapist becomes ‘inducted’ into the individual’s or family’s dysfunctional patterns.  Text books teach us about ‘transference’ and ‘counter-transference’ between a client and a therapist and identify it mostly as a bad thing that the practitioner would want to avoid at all times. This is in reference to a client engaging with the therapist as if he or she were the individual whom the client has the most unresolved material with such as a primary care giver from childhood. When the therapist is unaware that these projections are occurring and unconsciously becomes defensive by responding with their own projections; it is at this point that the therapist has become ‘inducted’. The job of the therapist is to help the client identify their own dysfunctional patterns and change them. In order to do this it is important to ensure that the therapist not become part of the dysfunctional patterns.

One of the most common forms of ‘induction’ that I have experienced is in working with individuals or families that generate and feed off of a lot of drama and chaos. It’s very easy to get pulled into this because there is a very real and palpable energetic vortex around chaos and drama. It will touch in on and trigger all of our cellular imprinting around survival including when ours hung in the balance. So when sitting with someone whose adrenals become activated while telling their story about who did what to whom and why; it’s hard not to notice how easy it is for our adrenals to become activated. The trick is to just notice it without responding to it.  And this is one example of what I was referring to in the last article when I identified that the therapist’s shtuff is always going to be in the room. What’s important is that they know it and not defend that it’s true when engaged with the client regarding the client’s shtuff. After all, the client is paying you to focus on their shtuff. So a perfect example of the therapist maintaining appropriate boundaries in this case is to ensure that they are in control of the session by not allowing the client to continue to ‘spin’ in their vortex of chaos and drama.  This can be achieved with heart and loving kindness. Boundaries are actually evidence of heartfelt, loving kindness being expressed because they are, by their very existence, evidence that the self and the other are considered sacred and worthy of consideration.

In addition to practicing from the heart, intimacy requires that there be transparency in the relationship and transparency is best achieved when the therapist is able to be empathic. During the 1980’s and 1990’s, an Italian neurophysiologist, Dr. Rizzolatti, discovered mirror neurons in the frontal lobes of the brain which are neurons that ‘fire’ when we perform an action as well as observe the same action in others. Further research using fMRI’s has demonstrated that this mirroring system is the neural basis of the human capacity for emotions such as empathy. Empathy is feeling and experiencing what the other is feeling and experiencing while always maintaining focus on, and directing attention to, the other. Being able to do this allows you to acknowledge and affirm the other’s experience on a much deeper level than is usually achieved in a casual relationship.

Over the years, I have stopped counting how many times a client has unburdened a deeply held secret for the first time in one of our sessions. They could not tell their wife, husband, mother, father, best friend, pastor, priest, rabbi, shaman, or spiritual teacher but for some reason they were able to tell me. I’ve come to understand that this level of intimacy is only possible when the therapeutic ‘space’ that is being ‘held’ for the client is filled with heart and absent of any judgment as evidenced by my ability to empathize with what they are feeling in the moment which usually includes excruciating levels of pain, shame and guilt. It takes tremendous 'presence', 'strength', and 'stamina' to hold this quality of 'space' for any length of time. But, whenever possible, the results are deeply moving and profoundly sacred. I've come to understand that this is the space in which miracles happen and I never cease to be humbled by the courage and grace that my clients continue to bring to this experience.

Reverence, compassion, and heartfelt, loving kindness are all hallmarks of a sacred experience. Any relationship that occurs within this ‘space’ would be considered intimate. Maintaining this frequency along with appropriate therapeutic boundaries allows for the client to experience emotional safety in a way never before experienced in any other relationship. This renewed sense of safety lays the groundwork for the client to have a corrective emotional experience. Only when the client feels this degree of safety can they allow themselves to drop their defense mechanisms and become truly transparent. Only then, when the client allows themselves to be truly 'seen', can any significant, long-term changes occur.


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    Kate O'Connell is a licensed Child and Family Therapist with a private practice in Charlottesville, Virginia addressing the therapeutic needs of children, adults, adolescents, couples and families. Her extensive training in Intensive In-Home Services,  Addiction, Family Systems Therapy and Energy Medicine enables her to facilitate positive outcomes for her clients dealing with a variety of emotional and mental health issues.

    



    

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