The Relationship is the Therapy

Posted by Peter Allen, MS, NCC on March 26, 2015

When clinicians are being trained in the craft and art of providing therapy, we are taught to be attentive to so many things. Of course we were taught to keep a very high degree of awareness and to be attuned to our clients’ state of being. However, I remember being trained to have awareness of: my posture, tone of voice, the pacing of my words, eye contact, what my hands were doing, my own feelings, moods, and triggers, body sensations, clinical formulations and diagnoses, and of course, personal biases. Now, this may seem like a whole lot to keep track of while attending to someone else… and it is.

However, there is a single guiding principle that informs all of my work with clients, and allows me to keep my awareness focused on that which matters most in the process of therapy: the relationship. Yes, the relationship is queen, king, and emperor in the process of healing. Medical doctors call this “bedside manner.” In our discipline, it is known as “therapeutic alliance.” Experienced clinicians know that without therapeutic alliance, there can be no therapy that takes place. Allow me to back up a bit to explain the significance of all of this.

First, what we do at Evoke Therapy Programs is psychotherapy. The prefix of this word delineates that we are concerned with matters of the soul and of the mind. This is different than what a physical therapist does, for instance; she or he is clearly concerned with matters of the body. If the presence of the word soul surprises you, let us examine the Greek origins of the words that create the term psychotherapy. The eminent Jungian psychotherapist James Hollis reminds us that the word psyche in English has come to be synonymous with the mind, but it comes from the Greek word psykhe, which actually signifies soul, mind, spirit, breath, and even life. Second, the English word therapy comes from the Greek word therapeuein, which means curing, healing, waiting on, listening to, or attending to. Thus, psychotherapy means, “attending to/healing the soul.” So I operate from this perspective, that the work I am doing is concerned with matters of the mind and the soul.

Wilderness therapy lends itself to the development of a powerful therapeutic alliance. This is due to the intensity of the shared experience, the prolonged contact I have with my clients, the positive peer and staff culture and the supportive milieu overall. When my clients present as oppositional, angry, manipulative, or distraught, as they often do in the beginning, I have the ability to simply attune to them and to wait. I have found from experience that the most powerful intervention is often simply being with them, desiring and judging nothing. My patience and my compassion are the best tools in the toolbox at this stage. By always returning to the idea that we are doing the work of the soul, I can connect to the client’s personal pain and struggle instead of getting mired in the agenda of needing to “fix” him early on. I see the person through the pathology; I see how his pathology makes sense given his individual life and situation. This is a hallmark of developing a working therapeutic alliance: the client’s pain and struggle makes sense given his or her context. Working in close conjunction with our excellent team of field staff, we accept our clients as they are, and meet them where they are. Because we do this, they are often willing to move with us to new places, and to try new ways of being and operating in the world. As I am fond of saying, it is no magic trick… Which is not saying that it is easy.

In an article I have greatly enjoyed, Dr. Robert-Jay Green, a Professor of Psychology at the California School of Professional Psychology, asserts, “No array of clever, change-oriented techniques is effective in the absence of a positive emotional connection between therapist and client.” This article so perfectly captures the importance of this connection, and how change and productivity both flow from this starting point.

Here is a link to this article: http://www.psychotherapy.net/article/therapeutic-alliance

Establishing a working therapeutic alliance is paramount to helping clients make lasting, significant change. For me, so much of my focus in the wilderness is on developing this with the adolescent males with whom I work. They often arrive at our program distrustful of adults in general, and so it is crucial that my first step always be to develop trust and buy-in with these young men. I think the only way to do this is to approach my clients with empathy, patience, humility, acceptance, and non-judgment. When they have received these things from me, it is amazing to bear witness to the changes they can make.

Very recently, I had the pleasure of reconnecting with a former client of mine, who is now in college. I was struck by what he shared with me. In a most heartfelt manner, he said, “it was nice to have somebody believe in me after everything I had done.” Now, please take note, he did not thank me for skills training, or for learning how to “bust” fires on his bow-drill set, or for the books I gave to him, or any other traditional intervention; he thanked me for believing in him. This was the most memorable aspect of our time together for him, and one I hope I am wise enough in the future to grasp in all of my work with clients. I have learned in my work that when the years have passed, more than anything else, our clients remember the quality of our relationship.

Thank you for reading.

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