The Middle of the Therapeutic Relationship

(Read about the beginning of the therapeutic relationship.)

Since the client is unique, each therapeutic relationship and process will be different. The length and speed of the therapeutic process are quite impossible to predict. The middle phase of the therapeutic relationship can be long or short, just like the beginning or the end of it. It is common to try to over-simplify the therapeutic process by theorising it as a series of neat and ordered stages. This welcome illusion of the therapeutic process being easily understandable and predictable is a fiction. It is pretty stupid to expect the client to follow a template in their changing process.

The middle of the therapeutic relationship is characterised by the development of relational depth and growing trust as a consequence: the client trusting the helper, the helper trusting the client, and both trusting their therapeutic relationship and emotional development process. This means acceptance and understanding on many levels; a profound sense of sharing. The client and the helper might experience this as intimacy or mutuality. They can trust each other’s commitment to achieving and maintaining genuineness towards each other. They become more and more transparent and they see each other ever more clearly. In this period, the client’s self-acceptance needs to be achieved: the client recognising themselves as a person of value, with their own weaknesses and strengths.

The warmth that the helper expresses towards the client, showing their unconditional acceptance, can trigger self-protection in a client who experienced unpredictable and inconsistent loving during their earlier development. They can react in a strongly ambivalent way, since they crave and value intimacy but, at the same time, they feel fundamentally threatened by it, which provokes their suspicion or even anger.

According to Carl Rogers, there are special moments in a person’s life when they feel able to change, and the point of the therapeutic process is to facilitate this more often. The goal of the therapeutic relationship is to free the natural self-healing process within the client. We assume that people want to be mentally healthy as well as physically, and that they do have the potential to develop positive mental health. The goal of the therapeutic process is the removal of limitations created by the client in their earlier stages of development as systems for their self-protection. The client had to survive potentially damaging situations in their earlier life, so they developed complicated unique systems for self-protection. These might have worked for them in the past (or maybe not), but they became dysfunctional in their later life inhibiting their relationships. These limitations can include emotional and/or social isolation, denial, fear, lack of clarity or awareness of their own feelings, self-doubt that can paralyse them, and partial or complete self-rejection. Barrett-Lennard summarised the essence of the therapeutic process in 1987 with a wonderful image: ‘the passage from woundedness to hope’.

Change in the client can happen suddenly if the pressure towards it was building up for a while under the surface. Or the client may suddenly notice the effect of accumulated changes in themselves that developed slowly and gradually, almost imperceptibly over time. In this case the helper might have seen them long before the client themselves. The therapeutic process is about removing the limitations the client has previously built in themselves. It is not an easy journey; it has a pattern more like a rollercoaster. There are periods of stuckness on the way, regressions, and plateaus; the client often gets worse before they can get better. Sometimes people have to experience their position at its worst before they are able move on through it. I, as a helper, need to be comfortable with the client’s movements; I have to be a companion for them in their journey, even if the road is quite bumpy; even in the difficult periods when they appear negative, depressive, or irrational. When at a certain point of the therapeutic process we are stuck, we need to detect the locus of stuckness. If it is in the client, I mustn’t try to help them find ways out of their stuckness; I have to accept them in their state of stuckness and pay attention to them as they find their own way out of it. If the cause of the stuckness is in me or in the relationship, that is when I need to act directly to remove us from the stuckness. I also need to ‘show my workings’ to the client. I need to give them my personal resonance: my honest reaction as one human being to the other.

Before the client came to me to seek professional help, they tried their best to protect themselves from their difficulties. They might have denied some of their feelings; they might have avoided certain situations that would force them to experience those unwanted feelings; they might have restricted their ways of relating to others in order to protect themselves, to minimise the risk of potentially damaging situations. All these barriers that the client has constructed for self-protection, need to be explored, acknowledged and re-evaluated during the therapeutic process so that the client’s fear diminishes, and they become freer to live their life in a more fulfilling way. It is possible that the client has never before felt safe enough to allow these feelings into their awareness. During the therapeutic process, they begin to accept themselves as they are, to recognise that they are worthy of care and attention from themselves and others. They acknowledge that they have weaknesses and strengths, and that they are fundamentally a person of value. What I can do to support the client in their journey towards self-acceptance is consistently valuing them, and effectively communicating this to them; and supporting them in releasing the emotional restrictions they imposed on themselves previously. The most important part of the therapeutic work is the establishment of the core of self-acceptance. Once that is accomplished, the change is irreversible for the client. They feel empowered, full of energy; and they wish to make many changes in their life.

I, as a helper, also go through a process as a consequence of my therapeutic relationship with the client. It is a struggle for me to consistently offer unconditional acceptance and genuineness, and to be fully present at all times with my client to achieve relational depth in our therapeutic relationship. I am naturally self-critical, but I also have to accept myself as I am; to acknowledge the mistakes I make, for example missing moments of opportunities to encounter the client at a deeper level. I need to be able to recognise my mistakes as valuable learning opportunities.

I have to be fully involved in the therapeutic relationship, but not over-involved, whih could potentially be damaging for both the client and myself. Over-involvement would undermine the client’s trust in my professionalism and integrity. A way of potentially damaging over-involvement would be if I were not able to hear the client’s actual experience because I imagined them to be similar to my own. I need to constantly self-monitor by self-reflecting on my own experience with the client, clearly separating those from the client’s experiences. I have to recognise, acknowledge and feel comfortable with my own identity and involvement in the therapeutic relationship.

I have to always be extra careful not to direct, or give advice, because clients are often particularly vulnerable to the helper’s directions at the edges of their awareness, and they might want me to solve their problems for them, but I want them to be in charge of themselves. Relational depth brings the feeling of safety and self-confidence for both the client and the helper; confidence in each other and their therapeutic relationship.

The end of the middle of the therapeutic relationship is indicated by the fact that the client has faced and overcome most of the emotional blockages that have been inhibiting their life previously. The client begins to achieve self-acceptance, recognising themselves as a person of value with their weaknesses as well as their strengths. All this means that the client is freer now to make changes in their life.

(Read about the end of the therapeutic relationship.)