Irvin Yalom: Heals nothing more than a relationship

Question: Do you have some know-how, that works with all clients
?  - Yes there is! And it is the therapist-client relationship. Heals nothing more than a relationship.

I wrote about this in his book "Ekzistentsialinaya psychotherapy».

Here are excerpts from her.




I remember the two maxims of psychotherapy that I learned early in his training.

The first is "The aim of psychotherapy - to bring the patient to the point where it can make a free choice»

. The second "heal relations" - this is the most important lesson that the therapist must learn. In psychotherapy, there is no more self-evident truths; each therapist in clinical practice again and again to make sure that the patient healing itself meeting, regardless of theoretical orientation of the therapist.

If there is something proven psychotherapy research, it is the fact that the positive relationship between patient and therapist also positively associated with the outcome of therapy.

An effective therapist:

responds to their patients in a sincere manner;
it establishes a relationship that the patient feels as safe and receiving;
it shows plaque devoid of possessiveness warmth and a high degree of empathy;
Finally, he is able to "be with" the patient and "to grasp the meaning of" patient.

Somehow I have compared the psychotherapy process, which is observed on a cooking course: apparently, critical differences in Armenian dishes of eggplant, as well as in psychotherapy, due to "throw-in" additives "is the protocol." These supplements are most often refers specifically to the field of relationship, the therapist-patient relationship.

Effective therapy is different in that the therapist is often in contact with the patient humane and deeply personal way. Often, this contact is crucial in the treatment, but it does not fit into the official ideological doctrine, is not described in the psychiatric literature (usually because of shame or fear of censorship), he does not teach students (and because it is not covered by the formal theory, and therefore, that such training could help to "excesses»).

An excellent illustration of the true importance of meeting the therapist and the patient, we find in the book called "The decisive episodes in psychotherapy" (1959), which describes a series of episodes, therapists considered as a turning point in the treatment. The vast majority of these crucial episodes of the therapist comes from his professional role and in contact with the patient profoundly human way.

Here are some examples:

1. At this point, Tom [patient] looked at me and very clearly and slowly said: "If you throw me, I will have no hope." At that moment, I swept the complex and powerful emotions, consisting of sorrow, hatred, pity and feelings of incompetence. This phrase has become for me Tom "decisive episode." At that moment I was closer to him than to anyone else.

2. The therapist took the patient in connection with an acute condition on Saturday afternoon, and although the therapist was hungry and tired, he continued the session a few hours.

3. The therapist took the patient, which during the course of therapy developed symptoms that caused suspicion of cancer. While she was waiting the results of laboratory tests (which were negative), he held her as a child; she sobbed and was in a short-term psychotic state induced by fear.

4. Man therapist working with the patient, a young woman who has developed a strong positive eroticized transference to it that the therapeutic work would be impossible if he did not disclose to her some aspects of his personal life, which allowed the patient to separate in their perception of the therapist realistic moments of distortion.

5. During several sessions the patient abused therapist by attacking him personally and by questioning his professional competence. Finally the therapist exploded: "I started to bang his fist on the table and shouted:" Damn it, listen, why do not you just stop verbal diarrhea, ceased to attack me, and did not go last to the case - to try to understand ourselves. Whatever the shortcomings I may be, but I have them enough, they are not related to your problems. I am also a man, and today was a bad day ... "

6. The patient has been left in an abandoned house on the cliff, where you can be reached only by rickety wooden bridge. In this extreme situation, she called her physician, who arrived at the house, passed through the bridge, comforted her and drove home.

Other decisive episodes like these: the essence of each member of the meeting of two people and move away from artificial or ideologically prescribed "treatment" of a patient

. © Irvin Yalom