Most people ask, how does therapy work? What do you do? More than what happens, the real importance lies in how it happens. In truth, the most influential factor in any therapeutic intervention is the relationship between the therapist and the client.
That is why it is so important that your therapist is someone that you are comfortable around…
So how does the
‘therapeutic relationship’ work?
There are 5 basic relationships that we witness in therapy. These can all be experienced throughout one intervention, and are all representative of different stages of the healing journey. Whilst there is no specific order to them they all tend to start with:
The working alliance
Think of this as an agreement. It’s something that you enter into with anyone you meet, but whilst it’s normally unwritten – in therapy, it is stated obviously, and often written down in confirmation.
So what kind of an agreement is it? Well, it’s the kind that says:
“I’ll work on this even when I don’t want to”…
Each agreement is unique, but it involves the following elements:
E.g. time (when you’ll meet), space (where you’ll meet), confidentiality (that the client has the power to share whatever they want, but the therapist won’t) and safety (to ensure the client is not harmed, or of harm to anyone else).
Boundaries lay out expectations for both the therapist and the client. They may appear to be easy expectations, but they help us create a consistent, trustworthy environment so you can feel safe to explore whatever you feel at the time.
It’s important to establish early on what you as a client want from the intervention. This goal can be anything you like. For example, you may decide to want to reconnect with a parent, forgive someone or build confidence.
No goal is too big or small. However, when you’re dealing with messy emotions or memories, this goal can be the reminder of why you’re going through the experience. Similarly, it helps the therapist stay on track when supporting you.
You aren’t expected to walk into therapy with a to-do list, and the therapist is not there to tell you what to do either. However, the agreement of important tasks that will help you reach your goal can be a good start.
For example, if we look at the idea of reconnecting with a parent, the tasks may include: speaking to the parent, reflecting on what you lost when you disconnected from the parent, or exploring the good and bad that surrounded the events that took place.
It’s not expected that all of this will be listed bit by bit on the working alliance, but it may help to recognise that it will take a few steps before you are ready to complete the goal.
For me, the most important element of the alliance is acceptance.
By that I mean, ensuring the client knows that all feelings are welcome. All ideas and concepts are welcome. That no matter what they say or do (as long as it is not causing harm to themselves or others), they will be accepted.
This is one of the most fundamental elements to good therapy. How are you going to be honest with yourself, if you feel like the person you are talking to is not going to accept you completely? That threat is often what scares us from being honest and open to exploring elements of ourselves that aren’t always considered socially acceptable.
This is what makes therapy unique… Your therapist is not your friend or family member, or anything of that sort. Your therapist is one person that will allow you to be completely yourself, and hold a mirror up to help you see how you affect the world and the world affects you.
All without any bias or personal agenda towards the outcome.
An on-going process
Your working alliance may grow and change throughout the intervention, and that is absolutely fine. We don’t always know what we need at the start, and sometimes our outcomes change to reflect our changing needs and growing understanding of ourselves.
Ultimately, YOU are in charge of the alliance, and the speed at which your intervention takes place… You are always in control.
I’ll explore more ‘therapeutic relationships’ in the next few posts…