The Helping Relationship: Healing and Change in Community Context

I. The Therapeutic Relationship and Techniques: How Clients Bring about Desired Changes

1 Introduction The twenty-first century is indeed an exciting time in which to live because of the many technological advances that pervade all segments of our society. Information technology allows us in seconds to connect to and communicate with people regardless of where they live. Technology has opened the door to outerspace exploration and has advanced medical diagnostic and surgical procedures. One stands in awe in the face of all these advances and humbly ponders whether the best is yet to come. Fascinated by the technological advances in medicine, communication , and outerspace exploration, psychotherapists and psychotherapy researchers ponder whether there are techniques that could raise the emotionally distraught out of their pain and sorrow and into a state of inner peace and harmony with fellow man and woman. Psychotherapists have, for generations, searched for and designed techniques that would act as potent instruments in facilitating personal and interpersonal growth and change. Free association and interpretation represent the first such attempts (Freud, 1940). They were followed by empathic responding (Rogers, 1951), behaviour rehearsal, systematic desensitization (Yates, 1975), and I The Therapeutic Relationship and Techniques: How Clients Bring about Desired Changes Augustine Meier 2 Therapeutic Relationship and Techniques healing images (Sheikh, 2003), to mention only a few. More current techniques include eye movement desensitization and reprocessing (Shapiro, 2001), neuro-linguistic programming (Grinder & Bandler, 1983), and emotional freedom technique (Craig, 1999). The fascination with techniques and their potential power to render changes has sparked, over the decades, an intense and vociferous debate among psychotherapy researchers on the relative effectiveness of the therapeutic relationship and of techniques on the therapeutic change process and a successful outcome. Most therapists have found themselves on one side or the other of this ongoing debate. Today there is a growing recognition that therapeutic techniques do not have inherent capacities to bring about changes but, in tandem with the therapeutic relationship, contribute to the therapeutic change process. The unanswered question is this: how do these two factors work together to bring about the desired change? Where in the therapist-client interaction do these two factors intersect? What needs to emerge when these two factors interact so as to bring about change? It has been postulated that the interaction of these two factors contributes to positive therapeutic outcomes when they, in tandem, are able to awaken in the client that which is new and life giving and the client owns it and lives from it. This chapter first summarizes the two positions of the debate by briefly presenting the assumptions of authors who adhere to one or the other of the two viewpoints. The chapter then addresses the theoretical and research literature concerning the interplay of the therapeutic relationship and techniques on the change process . The third part presents the thesis of this chapter, which is that the relationship and technique are said to interact when the client is able to take from them something new and life giving, owns it and lives from it, and refuses to look back. The last part presents cases that demonstrate how clients used the therapeutic relationship and the technique to promote inner healing and psychological growth and to develop more meaningful and healthier interpersonal relationships. Meier 3 The Therapeutic Relationship and the Change Process When there is a discussion about the therapeutic relationship, one typically focuses on the therapist and his or her therapeutically effective qualities and characteristics. Yet the therapeutic relationship comprises the engagement, encounter, and working together of both therapist and client. Freud was one of the first therapists to discuss the mutual commitment and collaboration of both the client and the therapist in this relationship. He stated that, when the patient and the psychoanalyst agree to engage in the psychoanalytic process, the patient promises “complete candour ... to put at our disposal all of the material which his self-perception provides ... that comes into his head, even if it is disagreeable to say it” (1940, pp. 36-38). The psychoanalyst assures the patient “the strictest discretion” (p. 36) and the application of his or her skill in interpreting material that has been influenced by the unconscious. The therapeutic relationship, in essence, comprises a real relationship (between therapist and client), a working arrangement or alliance regarding the goals of therapy and the means to achieve them, an emotional bond between therapist and client (Bordin, 1976), and client transferences and therapist countertransferences. A discussion of the therapeutic relationship, therefore, entails...