There are many ways in which therapy is a partnership - and needs to be - and yet, by its nature it is not an equal one nor fully mutual. It is the patient who comes to see a therapist and pays for their services, not vice-versa. In order to facilitate this process of healing, there is a contract which puts the client's subjective experience at the center and there is an agreement to attend to the therapist's subjective experience only insofar as it may be helpful to the client. The therapist offers her/himself to be used in the service of the healing process.
The clinician needs to hold the psychotherapeutic relationship as a sacred trust. As one teacher advised: "let your patients matter to you, to let them enter your mind, influence you, change you - and not conceal this from them." Another teacher put in this way: "Psychotherapy is a matter of the heart."
The Stone Center
My own work has been strongly influenced by the pioneering approach of Stone Center at Wellesley College. I see the writings of Judith Jordan, Jean Baker Miller et. al. as a significant breakthrough in terms of their analysis of dyadic relationships. They chose to consider the relationship itself to be central to the process of healing. And they have used psychotherapy as a window into the deep dynamics of our culture, describing the salient differences between two kinds of power in relationship.
These scholars understood that partnership has another dimension besides collaboration - and this additional dimension has two linked aspects: one is mutuality and the other is empowerment.
In 1976, Jean Baker Miller published Toward a New Psychology of Women and a small group of women psychotherapists began meeting in her living room. Through listening to each other, to their women clients, to other feminist writers, and by critiquing prevailing psychotherapy theory - largely developed by men - their process gave birth to a new model for psychotherapy called Relational-Cultural Therapy (RCT).
RCT recognizes our need for "growth-fostering relationships." Some of the first things they recognized is that there were aspects of women's psychology generally overlooked by most theories, that there needed to be much greater recognition of the essential cooperative nature of human existence, and that throughout time, women have assumed the greater responsibility for providing this element of relationships. Also obvious was the disempowered status of women in patriarchal culture.
Although their model dealt with psychotherapy per say, the Stone Center group soon realized that their insights applied to all relationships. RCT places relationships at the center of our human lives and tends to view psychological ill-health as the result of chronic disconnection in relationships within a culture (and psychological theory) that has over-valued power and independence. Gregory Bateson called this "the myth of self-power."
RCT holds that there are three core relational processes, all of which are expressions of mutuality: mutual empathy, mutual empowerment and mutual responsiveness.
Mutuality is present when the therapist is open to being affected by the client at the same time that the client's growth process is catalyzed by the therapist's interventions. This feedback loop makes all the difference. In this way the opportunity for mutual growth and change arises.
The Stone Center scholars had begun with a bold analysis of power in the therapist-patient relationship, which until that time had essentially remained unexamined. In traditional psychoanalysis, although beginning to be out of vogue, the patient lays supine on a couch with the therapist behind them, essentially out of sight - a vulnerable position indeed. Even today many therapists will have various trappings of expertise on display - diplomas, licenses, etc.
At the same time, they recognized that their analysis actually applied across the board: to the realities of power in all relationships:
"In the 'power-over' or 'power-for-oneself only' model there is an assumption of an active agent exerting control that [arises from] an actual or threatened use of power, strengths or expertise. [Whereas]
-- The alternative model of interaction that we are proposing might be termed 'power-with,' ['mutual power'], or 'power-together'... It suggest[s] that all participants in the relationship interact in ways that are based on connecting and enhancing everyone's personal power."
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